妇科患者危重病情变化早期预警评估表的构建及验证  

Formulation of early warning assessment scale system for the critical illness changes on gynecologic patients and the test of its predictive effectiveness

作　　者：乔成平 曾丽华[1] 赵蕾 方一宇 乔敏敏 叶敏[1] 张慧雯 刘娅玲 汤聪 屈敏 许华华[1] QIAO Chengping;ZENG Lihua;ZHAO Lei;FANG Yiyu;QIAO Minmin;YE Min;ZHANG Huiwen;LIU Yaling;TANG Cong;QU Min;XU Huahua(Department of Gynecology,Women’s Hospital of Nanjing Medical University,Nanjing,210004,China)

机构地区：[1]南京医科大学附属妇产医院妇科肿瘤病区,南京市210004

出　　处：《中华护理杂志》2021年第1期21-27,共7页Chinese Journal of Nursing

基　　金：南京市医学科技发展项目(YKK19177)。

摘　　要：目的构建妇科患者危重病情变化早期预警评估表,并对预测效果进行验证。方法采用回顾性病例分析,收集南京市某三级甲等医院2018年1月1日-2019年7月31日389例妇科患者资料,确定影响妇科患者危重病情变化的因素,构建妇科患者危重病情变化早期预警评估表,并检验预测效果。结果妇科患者危重病情变化早期预警评估表纳入疾病类型、呼吸频率、心率、收缩压、血氧饱和度、是否吸氧、意识、体温、下腹痛、血红蛋白浓度、阴道流血量、相关症状共12项预警指标,其中是否吸氧、体温、下腹痛、阴道流血量赋值0~2分,其余指标赋值0~3分,12项指标评分相加为总分,总分为0~32分;ROC曲线的最佳截断值为3.5分,灵敏度为92.32%,特异度为88.85%。结论妇科患者危重病情变化早期预警评估表能有效预测妇科患者危重病情变化的风险,有助于提高妇科危重症患者救治的成功率。Objective To construct the gynecological early warning score(GEWS)of critical patients and to test its predicted performance.Methods Using retrospective case analysis,we collected 389 cases of critical illness changes in gynecological patients from January 1,2018 to July 31,2019 in a level A tertiary hospital in Nanjing.The data was analyzed by single factor and multi-factor analysis to determine the relevant factors of gynecological critical illness changes and construct the GEWS table of critical illness to test the predictive effect of the scale.Results GEWS included 12 early warning indicators,including disease type,respiration rate,heart rate,systolic blood pressure,blood oxygen saturation,oxygen inhalation,consciousness,body temperature,lower abdominal pain,hemoglobin content,vaginal bleeding and related symptoms.Oxygen,body temperature,lower abdominal pain and vaginal bleeding are valued of 0 to 2 points,while other indicators were 0 to 3 points,with a total score of 0 to 32 points for 12 indicators;the best cutoff point of ROC curve was 3.5 points,with a sensitivity of 92.32%and a specificity of 88.85%.Conclusion The GEWS table can effectively warn the changes of critical gynecological conditions and predict the risks of changes in critical gynecological conditions,and help to improve the success rate of gynecological critical patients.

关 键 词：预警评估表 危险因素 风险评估 妇科学 护理 

分 类 号：R473.71[医药卫生—护理学]