改良早期预警评分结合心电图Sa O2在评价急性胸痛患者病情严重程度中的临床价值  

Clinical Value of Modified Early Warning Score combined with Electrocardiogram and Sa O2in Evaluating the Severity of Acute Chest Pain

作　　者：曾宇[1] 麦泉云[1] 欧阳后华[1] 杨新疆[1] 罗乃琨 ZENG Yu;MAI Quanyun;OUYANG Houhua(Qinzhou Second People's Hospital, Guangxi Qinzhou 535099, China)

机构地区：[1]广西壮族自治区钦州市第二人民医院急诊科,广西钦州535099

出　　处：《河北医学》2019年第4期548-551,共4页Hebei Medicine

基　　金：广西医药卫生科研课题;(编号:桂卫Z2010102)

摘　　要：目的:探究改良早期预警评分(MEWS)结合心电图、血氧饱和度(SaO2)在评价急性胸痛患者病情严重程度中的临床价值。方法:以2017年9月至2018年9月急诊科接诊的1080例急性胸痛患者为研究对象,进行MEWS评分和MEWS结合心电图、SaO2评分,并安排专人负责追踪患者预后,采用Cox回归模型进行生存分析。结果:预后越差的患者MEWS评分及联合评分越高,差异有统计学意义(P<0.05);且住ICU及急诊死亡患者联合评分显著高于MEWS评分,差异有统计学意义(t=3.241,4.006,P <0.05); Cox回归生存分析结果显示,MEWS评分(P=0.038)、心电图评分(P=0.022)、SaO2评分(P=0.015)及联合评分(P=0.014)均为急性胸痛患者死亡的独立危险因素,其中联合评分(HR=3.720)对患者预后死亡的预测价值更高。结论:MEWS评分结合心电图、SaO2监测有助于及时、准确评价急性胸痛患者病情严重程度,预测潜在风险,值得推广应用。Objective: To explore the clinical value of modified early warning score (MEWS) combined with electrocardiogram (ECG) and blood oxygen saturation (SaO 2) in evaluating the severity of acute chest pain. Methods: A total of 1080 patients with acute chest pain received in the emergency department from September 2017 to September 2018 were studied. MEWS score and MEWS combined with electrocardiogram and SaO 2 score were performed. A special person was assigned to follow up the prognosis of patients. Cox regression model was used for survival analysis. Results: The worse the prognosis, the higher the MEWS score and the combined score, the difference was statistically significant (P<0.05). The combined scores of ICU and emergency death patients were significantly higher than those of MEWS (t = 3.241, 4.006, P<0.05). Cox regression survival analysis showed that MEWS score (P=0.038), electrocardiogram score (P=0.022), SaO 2 score (P=0.015) and combined score (P=0.014) were all independent risk factors for death of patients with acute chest pain, and the combined score (HR=3.720) had higher predictive value for prognosis death of patients. Conclusion: MEWS score combined with electrocardiogram and SaO 2 monitoring can help to timely and accurately evaluate the severity of acute chest pain and predict potential risks.

关 键 词：改良早期预警评分 心电图 血氧饱和度 急性胸痛 

分 类 号：R459.7[医药卫生—急诊医学]