MEWS、NEWS和APACHE Ⅱ在急性中毒危重患者预后判断中的应用  

Application of MEWS,NEWS and APACHE Ⅱ in prognosis of critical patients with acute poisoning

作　　者：方婷婷[1,2] 肖江琴[1] 王海燕[1] 李萍[1] 

机构地区：[1]新疆维吾尔自治区人民医院,乌鲁木齐830000 [2]石河子大学医学院

出　　处：《山东医药》2015年第47期14-16,共3页Shandong Medical Journal

基　　金：新疆维吾尔自治区科技支撑项目(201442115)

摘　　要：目的比较改良早期预警评分(MEWS)、英国国家早期预警评分(NEWS)、急性生理和慢性健康状况评分(APACHEⅡ)在急性中毒危重患者预后评估中的应用价值。方法 420例急性中毒危重患者,分别进行MEWS、NEWS、APACHEⅡ评分,观察3种评分与患者30 d预后的关系,并通过ROC曲线比较3种评分对患者预后预测的准确性。结果 MEWS、NEWS、APACHEⅡ评分分值越高,患者病死率越高,P均<0.05。MEWS、NEWS、APACHEⅡ评分判断急性中毒危重患者预后的ROC曲线下面积分别是0.982、0.777、0.986,MEWS、APACHEⅡ与NEWS的ROC曲线下面积比较,P均<0.05,MEWS与APACHEⅡ的ROC曲线下面积比较,P>0.05。结论 3种评分系统均能够有效预测急性中毒患者预后,APACHEⅡ、MEWS评分预测的准确度相当,均较NEWS评分高,但MEWS评分简单、易行,更适合急性中毒危重患者早期预后的评估。Objective To compare the application of Modified Early Warning Score（ MEWS）,National Early Warning Score（ NEWS） and Acute Physiology and Chronic Health Evaluation II（ APACHE Ⅱ） in the prognosis of critical patients with acute poisoning. Methods We chose 420 cases of critical patients with acute poisoning for MEWS,NEWS and APACHEⅡ. We observed the relationships between three scores and 30-day-prognosis,and then we compared the accuracy of three scores in predicting the prognosis through ROC curve. Results The higher the scores of MEWS,NEWS and APACHEⅡ were,the higher fatality rate would be（ all P〈0. 05）. The ROC curves of MEWS,NEWS and APACHEⅡwere respectively 0. 982,0. 777 and 0. 986,and the difference was statistically significant between MEWS,APACHEⅡand NEWS（ all P〈0. 05）,but no significant difference was found in the ROC curve between MEWS and APACHEⅡ（ P〈0. 05）. Conclusions All these three scores can predict the prognosis of critical patients with acute poisoning. The accuracy of prediction is almost the same between APACHEⅡ and MEWS,both higher than NEWS. However,MEWS is simple and easy,so it is more suitable for early assessing the prognosis of critical patients with acute poisoning.

关 键 词：改良早期预警评分 英国国家早期预警评分 急性生理和慢性健康状况评分 急性中毒 

分 类 号：R595[医药卫生—内科学]