血清D-D与危重评分对重症患儿预后的预测价值分析  

Analysis of the Prognostic Value of Serum D-D and Critical Score in Severe Children

作　　者：叶韶勤 YE Shaoqin(Jiujiang Maternal and Child Health Hospital,Jiujiang 332000,China)

机构地区：[1]江西省九江市妇幼保健院,江西九江332000

出　　处：《中国医学创新》2018年第34期138-141,共4页Medical Innovation of China

摘　　要：目的:探讨血清D-二聚体与小儿危重病例评分对预测重症患儿预后效果的价值并进行分析。方法:选取2017年1月-2018年1月来本院PICU进行治疗监护的99例患儿,根据小儿危重病例评分对上述患儿进行分组,分别是普通组32例、危重组46例、极其危重组21例,比较三组之间的患儿好转率的差异并对D-二聚体与危重评分的相关性进行分析,探讨两者对重症患儿预后的预测价值。结果:普通组、危重组与极其危重组的好转率相比,差异均有统计学意义(x^2=4.93、4.48,P<0.05),而危重组与普通组之间的好转率比较差异无统计学意义(x^2=0.16,P>0.05)。普通组、危重组、极其危重组(不包括危重单项指标)的PICS的平均值分别为(93.06±3.12)、(83.09±4.18)、(66.00±3.20)分,普通组、危重组、极其危重组的D-二聚体水平的四分位间距分别为0.60(0.40,2.00)、0.85(0.60,2.20)、1.00(0.50,3.90)mg/L。D-D二聚体与危重评分之间具有极强的负相关性(r=-0.546,P<0.05)。结论:通过对小儿进行危重病例评分与血清D-D二聚体浓度检测,可以较好地判断重症患儿的预后效果以及病情发展,可以针对性地对极其危重组的患儿采取更加积极的治疗和更为完善的护理措施,可以有效提高患儿的病情好转率,改善患儿的预后效果。Objective:To investigate the value of serum D-D and pediatric critical case scores in predicting the prognosis of severely ill children and analyze the results.Method:A total of 99 children who weretreated in PICU in our hospital from January 2017 to January 2018 were selected and grouped according to the critical case scores of children.They were divided into normal group of 32 cases,dangerous reorganization of 46 cases and extremely dangerous reorganization of 21 cases.The difference of improvement rate among the three groups were compared,the correlation between D-dimer and critical score were analyzed,the predictive value of D-dimer and critical score in the prognosis of severe children were explored.Result:There were significant differences in the success rate of the normal group,the critical group and the extremely critical group( x^2=4.93,4.48;P<0.05),but there was no significant difference in the improvement rate between the critical group and the ordinary group( x^2=0.16,P>0.05).The average values of the PICS of the common group, the critical recombination and the extremely critical reorganization(excluding the critical single index) were respectively(93.06±3.12),(83.09±4.18) and(66.00±3.20)scroes,the range interquartile of the three groups were respectively 0.60(0.40,2.00)、0.85(0.60,2.20),1.00(0.50,3.90)mg/L.There was a strong negative correlation between D-D dimer and critical score(Pearson coefficient method),the correlation coefficient(r=-0.546,P<0.05). Conclusion:By measuring critical cases of children and serum D-D dimer concentrations,we can better judge the prognosis of patients with severe disease and the development of the disease,can be targeted for more aggressive treatment of children with extremely dangerous reorganization and more perfect nursing measures can effectively improve the improvement rate of children’s conditions and improve the prognosis of children.

关 键 词：血清D-D二聚体 小儿危重病例评分 重症患儿 预测价值 Pearson系数法 

分 类 号：R720.597[医药卫生—急诊医学]