改良早期预警评分评估腹部闭合性损伤的价值  

Value of Modified Early Warning Score in evaluation of closed abdominal injury

作　　者：丁高潮 董静[1] 

机构地区：[1]湖北省麻城市人民医院急诊科,麻城市438300

出　　处：《广西医学》2015年第11期1580-1582,共3页Guangxi Medical Journal

基　　金：湖北省科技计划研究与开发项目(2010C065)

摘　　要：目的探讨改良早期预警评分（MEWS）对腹部闭合性损伤病情评估的价值。方法分析腹部闭合性损伤急诊患者164例的临床资料,采用MEWS评价病情,按照MEWS评分分为0~3分组（51例）、4~6分组（56例）、7~9分组（34例）、〉9分组（23例）,分析患者入院的检查情况和分诊情况（入住ICU病房、专科治疗、门诊处理）、并发症发生率、入院后1个月的预后。结果 7~9分组、〉9分组患者入住ICU实施抢救的比例明显高于0~3分组、4~6分组患者（P〈0.05）;0~3分组与4~6分组、7~9分组与〉9分组入住ICU抢救的比例差异无统计学意义（P〉0.05）。4组腹腔穿刺阳性率、B超阳性率、CT检查阳性率、X线检查阳性率比较,差异无统计学意义（P〉0.05）。0~3分组、4~6分组康复患者比例明显高于〉9分组（P〈0.05）。〉9分组患者死亡率明显高于0~3、4~6、7~9分组,差异有统计学意义（P〈0.05）。4组并发症总发生率比较,差异无统计学意义（P〉0.05）。结论 MEWS评分能快速、准确地对急诊腹部闭合性损伤病情做出评估处理,对患者的预后有一定预测价值。Objective To explore the value of Modified Early Warning Score（ MEWS） in the evaluation of closed abdominal injury.Methods The clinical data of 164 emergent patients with closed abdominal injury were analyzed. MEWS was used to evaluate the severity of patients. And the patients were divided into three groups according to MEWS,including 0-3 scores group（ n = 51）,4-6 scores group（ n =56）,7-9 scores group（ n =34）,〉9 scores group（ n = 23）. The conditions of taking examinations and triage（ including ICU admission,specific treatment and outpatients management）,the incidence of complications and prognosis one month after admission were analyzed.Results The proportions of patients with rescue in ICU in the 7-9 scores group and 〉 9 scores group were significantly higher than that in the 0-3 scores group or 4-6 scores group（ P 〈 0. 05）,but significant difference in the proportions was found neither between 0-3sores group and 4-6 scores group nor between 7-9 scores group and 〉 9 scores group（ P 〉 0. 05）. There were no significant differences in the positive rates of abdominal cavity puncture,B ultrasonic examination,CT examination and X-ray examination among four groups（ P 〉 0. 05）. The proportions of patients with recovery in the 0-3 sores group and 4-6 scores group were significantly higher than that in the 〉 9 scores group（ P 〈0.05）. The mortality in the 〉9 scores group was significantly higher than that in the 0-3 sores group,4-6 scores group or 7-9 scores group（ P 〈 0. 05）. No significantly difference in the overall incidence of complications was found among four groups（ P 〉 0. 05）. Conclusion MEWS can contribute to conduct the quick and accurate management in emergent patients with closed abdominal injury,and has the certain value in predicting the prognosis of patients.

关 键 词：腹部闭合性损伤 改良早期预警评分 急诊 分诊 预后 

分 类 号：R656[医药卫生—外科学]