简化MEOWS预警对孕妇脓毒血症临床结局的影响研究  

Study on effect of simplified MEOWS early warning on clinical outcome in pregnant women with sepsis

作　　者：张欢 刘剑萍[1] 彭磊 潘传亮[1] 刘泽涵 ZHANG Huan;LIU Jianping;PENG Lei;PAN Chuanliang;LIU Zehan(Department of Intensive Care Medicine,Chengdu Municipal Third People′s Hospital,Chengdu,Sichuan 610000,China)

机构地区：[1]成都市第三人民医院重症医学科,四川成都610000

出　　处：《现代医药卫生》2021年第8期1271-1275,共5页Journal of Modern Medicine & Health

基　　金：四川省卫生健康委员会科技项目(18PJ447)。

摘　　要：目的探讨简化改良产科早期预警系统(MEOWS)对潜在危重症孕妇的筛查效能及对孕妇脓毒血症临床结局的影响。方法选取2018年8月至2019年8月该院及其直属基层医院收治的妊娠合并感染孕妇300例,经简化MEOWS预警脓毒血症患者150例纳入观察组,在疾病进展超早期启动产科快速反应团队(ORRT),最后29例患者确诊为脓毒血症,收治该院重症监护病房(ICU)。经MEOWS预警脓毒血症患者150例纳入对照组,同样程序启动ORRT,最后32例患者确诊为脓毒血症,收治该院ICU。比较2种方法的筛查效能,以及2组患者急性生理和慢性健康估测评分Ⅱ、序贯器官衰竭估计(SOFA)评分、ICU住院时间、总住院时间、流产发生率、胎膜早破发生率、新生儿重度窒息发生率等。结果与MEOWS预警比较,简化MEOWS预警对潜在危重症孕妇同样具有一定的筛查效能,但更简便,客观性更强。观察组患者刚入院时SOFA评分、胎膜早破发生率、流产发生率均更低,ICU住院时间更短,差异均有统计学意义(P<0.05);但简化MEOWS预警对孕产妇病亡、分娩时新生儿窒息情况无指导意义。结论经简化MEOWS预警对潜在脓毒血症孕妇进行筛查,对比MEOWS预警具有同等甚至较高的筛查效能,灵敏度高,可改善患者的临床结局。Objective To investigate the screening efficacy of the simplified Modified Early Obstetric Warning System(MEOWS)on the pregnant women with potential critical illness and its influence on the clinical outcome of pregnant women with sepsis.Methods Three hundreds pregnant women with complicating infection treated in this hospital and directly subordinate to primary hospitals from August 2018 to August 2019 were selected,in which 150 cases of sepsis by simplified MEOWS early warning were included into the observation group,in the super-early stage of disease progress,ORRT was started,finally 29 cases were definitely diagnosed as sepsis and admitted into ICU of this hospital.One hundred and fifty patients with sepsis by MEOWS early warning were included into the control group,ORRT was started by the same procedure,32 cases were finally diagnosed as sepsis and admitted into ICU of this hospital.The screening efficacies were compared between the two methods.The APACHEⅡscore,SOFA score,ICU hospitalization time,total hospitalization time,abortion rate,premature rupture rate of membranes,and neonatal severe asphyxia rate were compared between the two methods.Results Compared with the MEOWS early warning,the simplified MEOWS early warning had a certain screening efficacy on the pregnant women with potential critical illness,but which was more simple and convenient,and its objectiveness was more strong.The SOFA score just the time of admission,premature rupture rate of membranes and abortion rate in the observation group were lower,the ICU hospitalization time was shorter and the differences were statistically significant(P<0.05);but the simplified MEOWS for early warning of pregnant women death and neonatal asphyxia had no the guidance significance.Conclusion Screening the pregnant women with potential sepsis by simplified MEOWS early warning has the same,even higher screening efficacy and high sensitivity as compared with MEOWS early warning;which can improve the clinical outcome of the patients.

关 键 词：孕妇 脓毒症 改良产科早期预警系统 产科快速反应团队 

分 类 号：R631.1[医药卫生—外科学] R714.2[医药卫生—临床医学]