改良早期预警评分在院前急救中的应用研究  

Application study in pre hospital first aid of modified early warning score

作　　者：谢宜[1] 陈雪枝[1] 苏奕强[1] 郑瑞琪[1] 陈雪华[1] 蔡妙凤[1] 

机构地区：[1]广东省潮州市中心医院急诊科,521000

出　　处：《中国医师进修杂志》2014年第24期46-49,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨改良早期预警评分（MEWS）方法在院前急救中对患者病情评诂的应用价值.方法 对3 478例院前急救患者采用现场MEWS方法,评分分为0～4分、5～9分和≥10分.分析不同分数段患者的分布特点与病情的关系,并追踪患者入院后的去向及病情转归.结果 院前急救患者中MEWS以低分0～4分为主,占69.18％（2 406/3 478）,重症患者仅占2.58％（62/2 406）;MEWS 5～9分占21.54％ （749/3 478）,重症患者增加到37.92％ （284/749）;MEWS≥10分仅占9.29％ （323/3 478）,重症患者增加到87.00％（281/323）.MEWS分数段越高,重症患者的比率就越高,MEWS 5～9分及≥10分的重症患者比率与MEWS0～4分重症患者比率差异有统计学意义（P值均＜ 0.01）.MEWS 5～9分及≥10分患者入院后收住专科病房和重症监护病房治疗的比率较MEWS0～4分患者明显增加（P值均＜0.01）,病死率也显著增加,差异有统计学意义（P值均＜0.01）.结论 MEWS方法在院前急救中能早期预警潜在危重症的患者,评分分数段越高,病情越严重,病死率越高.Objective To investigate the application value of modified early warning score （MEWS） for assessment of patients in pre hospital first aid.Methods For patients with MEWS method in 3 478 cases of pre hospital first aid,scored in 0-4,5-9 and ≥ 10 points.Analysis of the relationship between the distribution and severity in patients with different grades,and tracing the fate and the condition of patients after admission.Results In MEWS patients with low 0-4 points was divided into pre hospital first aid,accounted for 69.18% （2 406/3 478）,severe cases accounted for 2.58% （62/2 406）; MEWS 5-9 accounted for 21.54% （749/3 478）,severe patients increased to 37.92% （284/749）; MEWS ≥ 10 points accounted for only 9.29% （323/3 478）,severe patients increased to 87.00% （281/323）.MEWS scores higher ratio in patients with severe more,MEWS 5-9 points,severe patients with MEWS ≥ 10 points 0-4 critical patients proportion （P 〈 0.01）.MEWS 5-9 points,≥ 10 points patients admitted to a specialist ward and intensive care units treatment compared with MEWS 0-4 points patients increased significandy （P 〈 0.01）,the mortality rate was also significandy increased （P 〈 0.01）.Conclusion The MEWS method in pre hospital first aid to early warning of potential in critically ill patients,the higher score,the more serious condition,the higher mortality rate.

关 键 词：改良早期预警评分 院前急救 病情评估 应用 

分 类 号：R459.7[医药卫生—急诊医学]