快速急诊内科评分和改良早期预警评分对重症中暑患者预后判断的比较研究  

Comparison of the rapid emergency medicine score and the modified early warning score in the prognosis prediction of intensive heat stroke patients

作　　者：晏晨[1] 魏捷[1] 田丹[1] 杨卫泽[1] 叶璐[1] 吕菁君[1] 杜贤进[1] YAN Chen WEI Jie TIAN Dan YANG Weize YE Lu LV Jingjun DU Xianjin(Department of Emergeney Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, Chin)

机构地区：[1]武汉大学人民医院急诊科,武汉430060

出　　处：《临床急诊杂志》2017年第9期655-658,共4页Journal of Clinical Emergency

基　　金：国家自然科学基金项目(No:81601670);湖北省自然科学基金项目(No:2014CFB302)

摘　　要：目的:比较快速急诊内科评分(REMS)及改良早期预警评分(MEWS)对重症中暑患者预后的预测价值,探讨更适合判断重症中暑患者病情的评分方法。方法:对34例重症中暑患者临床资料进行回顾性分析,分别比较存活及死亡患者入院RMES和MEWS差异,并通过受试者工作特征曲线(ROC曲线)对比两种评分对重症中暑患者预后判断的准确性。结果:存活及死亡患者入院REMS分值分别为5.15±3.21、7.88±3.36,差异有统计学意义(P=0.046);MEWS分值分别为6.12±2.92、9.25±2.05,差异有统计学意义(P=0.008);REMS和MEWS对重症中暑患者预后判断的ROC曲线下面积分别为0.736(95%CI:0.529~0.942)和0.810(95%CI:0.646~0.974),差异无统计学意义。结论:REMS和MEWS均能较好的判断重症中暑患者的预后,其中MEWS评分灵敏度更高,更适用于急诊及院前高危重症中暑患者的早期识别和筛查。Objective：To compare the application value of rapid emergency medicine score （REMS） and modi- fied early warning score （MEMS） in the prognosis prediction of intensive heat stroke patients. Method： The clinical information of 34 intensive heat stroke patients was retrospectively collected and analyzed. The admission REMS and MEWS score was compared between the intensive heat stroke patients. The receiver operating characteristic curve was used to identify and compare the value of admission REMS and MEWS in predicting the prognosis of intensive heat stroke patients. Result： The REMS score of intensive heat stroke was 5.15± 3.21 vs. 7.88 ± 3.36 for survived and died patients respectively. The difference was statistically significant with a P-value of 0. 046. The MEWS score was 6.12±2.92 vs. 9.25±2.05 respectively and the P-value was 0. 008. The area under the ROC curve of REMS and MEWS score in predicting the prognosis of intensive heat stroke patients were 0. 736（95 %CI： 0. 529±0. 942） and 0. 810 （ 95% CI： 0. 646 ± 0. 974） respectively, and the P-value was 0. 522. Conclusion： The REMS and MEWS scoring scale can precisely predict the prognosis of intensive heat stroke patients. The admission MEWS has a higher sensitivity and is more suitable in guiding the assessment and treatment of intensive heat stroke patients in pre-hospital and emergency department.

关 键 词：快速急诊内科评分 改良早期预警评分 重症中暑 受试者工作特征曲线 预后 

分 类 号：R594.12[医药卫生—内科学]