新生儿危重病例评分法在新生儿呼吸窘迫综合征中的应用  

Application of neonatal critical case scoring method in neonatal respiratory distress syndrome

作　　者：管峥 吴新萍 杭菲菲 GUAN Zheng;WU Xinping;HANG Feifei(Yangzhou Maternal and Child Care Service Centre,Yangzhou 225002,China)

机构地区：[1]扬州大学医学院附属医院扬州市妇幼保健院新生儿科,江苏扬州225002

出　　处：《中国中西医结合儿科学》2018年第3期236-238,共3页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的探讨新生儿危重病例评分(NCIS)在新生儿呼吸窘迫综合征(NRDS)中的适用性及其临床意义。方法选择2015年1月至2016年12月扬州大学医学院附属医院收治的NRDS患儿70例,按胎龄分为早期早产儿组(胎龄<34周)46例、晚期早产儿组(胎龄34～36+6周)16例和足月儿组(胎龄≥37周)8例。对全部患儿采用NCIS法10项评定、总分100分的评分方式来进行评分,初次评分在入NICU后24h内进行,隔天评分1次,取其最危重分值,如病情加重者立即评分,取最危重分值,病情继续恶化者,每天评分直至死亡为止,总分值>90分者为非危重,70～90分者为危重,<70分者为极危重,另对于符合单项指标一项或一项以上者亦可判定为新生儿危重病例。结果非危重病例在3组间发生率均较低,差异无统计学意义(P>0.05);危重病例在早期早产儿组和晚期早产儿组中的发生率均较高,但与足月儿组相比差异无统计学意义(P>0.05);极危重病例在足月儿组中的发生率最高,且与早期早产儿组、晚期早产儿组相比差异有统计学意义(P<0.05)。非危重病例中无死亡病例,3组极危重病例的死亡率均较高,且与非危重、危重病例比较差异有统计学意义(P<0.05)。结论 NCIS法对评估NRDS病情的严重程度及发展趋势有较好的帮助,还能用于预测死亡风险,并且为继续治疗及与家属沟通提供一定的依据。Objective To explore the applicability and clinical significance of neonatal critical case scoring（NCIS）in neonatal respiratory distress syndrome（NRDS）.Methods A total of 70 cases of NRDS child patients admitted to the Affiliated Hospital of Medical College of Yangzhou University from January 2015 to December 2016 were selected and divided into early preterm infant group（gestational age34 weeks,n=46）and late preterm infant group（gestational age between 34 and 36＋6 weeks,n=16）and full-term infant group（gestational age≥37 weeks,n=8）according to the gestational age.All children were scored by the 10 items of NCIS method with a total score of 100 points.The initial scoring was performed within 24 hafter entering NICU;the scoring was performed every other day,and the most critical score was taken;the patients with aggravation were scored immediately and the taken most critical score was taken;the patients with increasing aggravation were scored every day until the day of death.The children with a total score90 points were non-critical,70 to 90 points,critical,and70 points,extremely critical.The patients with one or more than one item of single index might also be judged as neonatal critical cases.Results The incidence rate of non-critical cases was low among the three groups（P〈0.05）.The incidence rate of critical cases was high in early preterm infant group and late preterm infant group,but the difference was not statistically significant compared with that in full-term preterm group（P〈0.05）.The incidence rate of extremely critical cases was highest in the full-term infant group,and there was a significant difference compared with early preterm infant group and late preterm infant group（P〈0.05）.There were no deaths in non-critical cases;the death rate in extremely critical cases was high among the three groups,and there was a significant difference compared with non-critical cases and critical cases（P〈0.05）.Conclusion NCIS method is helpful to assess the severity and dev

关 键 词：呼吸窘迫综合征 危重病例评分 早产儿 足月儿 

分 类 号：R725.6[医药卫生—儿科]