改良早期预警评分对重症肺炎患者病情评估和预后预测的价值  

The value of modified early warning score in condition assessment and prognosis of severe pneumonia patients

作　　者：方婷婷[1] 肖江琴[2] 李萍[3] 

机构地区：[1]石河子大学医学院护理系,新疆石河子832000 [2]新疆维吾尔自治区人民医院急救中心,新疆乌鲁木齐830000 [3]新疆维吾尔自治区人民医院护理部

出　　处：《中国急救医学》2015年第8期719-721,共3页Chinese Journal of Critical Care Medicine

基　　金：新疆维吾尔自治区科技支撑项目（201442115）

摘　　要：目的：探讨改良早期预警评分（ MEWS）对重症肺炎患者病情评估和预后预测的价值。方法选取我院急诊科收治的重症肺炎患者140例进行前瞻性研究，对患者进行MEWS和急性生理与慢性健康状况Ⅱ（ APACHEⅡ）评分，记录评分结果、获取结果所需时间及患者的预后情况；比较两种评分结果获取时间，分析两种评分与危重患者预后的相关性，并通过ROC曲线下面积比较两种评分预后预测的准确性。结果①MEWS评分结果获取时间明显少于APACHEⅡ评分获取时间（ P＜0．05）；②MEWS评分、APACHEⅡ评分分值越高，死亡危险率越高；③两种评分对重症肺炎患者的不良预后均有评估能力（P＜0．05），但两种评分比较差异无统计学意义（P＞0.05）。结论 MEWS评分与APACHEⅡ评分都能够有效地判断重症肺炎患者病情危重程度及预后情况，但MEWS评分操作简单，获取参数方便，便于在急诊重症肺炎患者中使用。Objective To discuss the value of modified early warning score （ MEWS ） in condition assessment and prognosis of severe pneumonia patients.Methods This prospective study included 140 severe pneumonia patients hospitalized into the emergency department. MEWS and APACHEⅡscore was calculated, its results and the time for getting this results and the prognosis of patients was recorded;the time for getting the two score results was cempared;the correlation of two score and prognosis of severe patients was analysed; two score prognostic accuracy was compared by the area under the ROC curve.Results ①The time for getting MEWS was significantly less than it for APACHEⅡ（ P〈0.05）;②The higher MEWS and APACHEⅡscore, the higher the risk of death;③Both of the two score had the ability to assess poor prognosis of severe pneumonia patients, but there was no statistical significance between the two scores （P〉0.05）.Conclusion MEWS and APACHEⅡscore can effectively judge the condition and prognosis of severe pneumonia patients, but MEWS is simple, easy to obtain parameters, so it is convenient for use MEWS in severe pneumonia patients in emergency.

关 键 词：改良早期预警评分(MEWS) 急性生理与慢性健康状况评分Ⅱ(APACHEⅡ) 重症肺炎 ROC曲线 

分 类 号：R563[医药卫生—呼吸系统]