产科“潜在危重症”评分的设计及对3269例孕妇病情评价的应用研究  

Design of obstetrical ＂potential severe disease＂ score and its application in 3269 pregnant women

作　　者：赵紫榆[1] 周小金[1] 汤月萍[1] 孙敏雅[1] 

机构地区：[1]无锡市妇幼保健院,江苏214002

出　　处：《中华危重病急救医学》2013年第5期298-300,共3页Chinese Critical Care Medicine

基　　金：江苏省无锡市科技计划项目（CSE01N1116）

摘　　要：目的评价产科“潜在危重症”评分法在妊娠晚期病情评价和母婴预后预测中的适用性和可行性。方法针对产科孕妇的病情特点设计产科“潜在危重症”评分法，对3269例住院分娩孕妇进行评分，并追踪母婴的预后。结果危重病例组（137例）产科“潜在危重症”评分的平均秩次较普通妊娠组（3132例）显著增高（2969．390比1576．630，Z=-18．052，P〈0．01），说明对病情评估有鉴别能力；其受试者工作特征曲线下面积（AUC）为0．926，最佳截断点为3分，敏感度为73．72％，特异度为92．21％。胎儿窘迫组（507例）产科“潜在危重症”评分平均秩次与正常胎儿组（2726例）比较差异无统计学意义（1572．920比1646．400，Z=-1．498，P〉0．05），说明该评分法对胎儿宫内窘迫无鉴别能力。结论产科“潜在危重症”评分法快捷、方便，对妊娠晚期的病情评价具有较好的鉴别能力，适合当今产科领域运用。Objective To-study the applicability and praetieability of ＂potential severe disease＂ score in prognosticating severity of potential disease in late pregnancy and puerperal mother and newborn. Methods ＂Potential severe disease＂ score was designed based on the characters of obstetrical patients, and 3269 puerperal women were surveyed and the condition of mother and child were investigated after delivery. Results The mean rank of ＂potential severe disease＂ score in the group with severe illness （n = 137 ） was extremely higher than that of smooth pregnancy group （n=3132, 2969.390 vs. 1576.630, Z=-18.052, P〈0.01）. The result indicated the score could evaluate the degree of illness. The area under the receiver operating eharaeteristie curve （ AUC ） of the ＂potential severe disease＂ score was 0.926, the optimal cut-off point of score was 3, with sensibility 73.72% ,speeifieity 92.21%. There was no significant difference in the mean rank of ＂potential severe disease＂ score between fetal distress group （n =507 ） and normal fetus group （n= 2726, 1572.920 vs. 1646.400, Z=- 1.498, P〉0.05 ）, therefore it indicated that the ＂potential severe disease＂ seore had not the identification ability on fetal distress. Conclusion Obstetrical ＂potential severe disease＂ score may be applied for obstetrics because of speediness, simplicity and better identification in evaluating the disease in late pregnancy.

关 键 词：潜在危重症 病情评估 高危妊娠评分 胎儿宫内窘迫 

分 类 号：R714[医药卫生—妇产科学]