两种评分预测新生儿坏死性小肠结肠炎预后的价值  

The predicting value of two kinds of score for acute physiology in the treatment outcome of necrotizing enterocolitis

作　　者：王战胜[1] 段道云 王栋[1] 胡广秀[1] 刘雨露[1] 高凌云[1] 

机构地区：[1]河南省商丘市第一人民医院NICU,476000

出　　处：《中国小儿急救医学》2015年第1期37-40,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的 分析新生儿急性生理学评分（score for neonatal acute physiologyⅡ,SNAP-Ⅱ）和新生儿紧急生理学评分补充（score for neonatal acute physiology-perinatal extensionⅡ,SNAPPE-Ⅱ）预测新生儿坏死性小肠结肠炎（neonatal necrotizing enterocolitis,NEC）的预后价值.方法 以本院儿科重症监护室2002年至2012年收治的确诊NEC病例73例为研究对象.根据手术情况将病例分为手术组和非手术组,根据预后结果分为存活组和死亡组.收集患儿的一般资料,比较不同组间SNAP-Ⅱ和SNAPPE-Ⅱ评分.结果 手术组的两项SNAP-Ⅱ和SNAPPE-Ⅱ评分[（27.0±2.3）分,（26.5±1.8）分]均高于非手术组[（14.0±2.1）分,（15.0±2.5）分],差异有统计学意义（P＜0.01）;死亡组的SNAP-Ⅱ和SNAPPE-Ⅱ评分[（31.0±3.2）分,（31.0±3.4）分]均高于存活组[（11.0±2.5）分,（10.0±3.6）分,P＜0.01].应用受试者工作特征（receiver operating characteristic,ROC）曲线分析,SNAP-Ⅱ和SNAPPE-Ⅱ评分预测手术风险的ROC曲线下面积分别是0.726和0.732,其预测手术风险的最佳值分别是20和24;预测死亡风险的ROC曲线下面积分别为0.752和0.825,其预测死亡风险的最佳值为31和33,差异均有统计学意义（P＜0.01）.结论 评价疾病严重程度的SNAP-Ⅱ和SNAPPE-Ⅱ评分能够预测NEC预后的手术风险,对NEC的临床诊断、治疗、跟踪和病情的后续发展具有意义.Objective To study the value of score for neonatal acute physiology Ⅱ（SNAP]Ⅱ） and its extension version Ⅱ （SNAPPE-Ⅱ） in predicting neonatal necrotizing enterocolitis （NEC） outcome.Methods We explored 73 NEC patients by statistics who were treated in our hospital from January 2002 to January 2012.The patients were divided into two groups：surgery group and non-surgery group,then they were divided into subgroups：alive group and death group.The general information including birth weight,age,clinical manifestations,treatment of patients were collected.Every patient was checked and scored by the methods SNAP-Ⅱ] and SNAPPE-Ⅱ in time.Results The scores （27.0 ± 2.3,26.5 ± 1.8） of surgery group including SNAP-Ⅱ and SNAPPE-Ⅱ were higher than those （14.0 ± 2.1,15.0 ± 2.5） in the non-surgery group（P ＜ 0.01）.The scores（31.0 ± 3.2,31.0 ± 3.4） of the death group including SNAP-Ⅱ and SNAPPE-Ⅱ were higher than those（11.0 ± 2.5,10.0 ± 3.6） in the alive group（P ＜ 0.01）.According to the area under the curve（AUC） analyzed by the receiver operating characteristic（ROC） curve for measuring the scores of surgery predicting,AUC was 0.726 for SNAP-Ⅱ and 0.732 for SNAPPE-Ⅱ.The value of predicting surgery risk was 20 and 24 respectively.According to the AUC analyzed by the ROC curve for measuring the scores for surgery predicting,AUC was 0.752 for SNAP-Ⅱ and 0.825 for SNAPPE-Ⅱ.The value of predicting mortality risk was 31 and 33 respectively.All P values were less than 0.01 and there were significant differences.Conclusion The two kinds of score for neonatal acute physiology have an important significance in predicting surgery and mortality risk of NEC.

关 键 词：坏死性小肠结肠炎 新生儿 

分 类 号：R722.1[医药卫生—儿科]