改良产科早期预警系统在孕产妇中的应用效果研究  

Application effect of Modified Early Obstetric Warning System in pregnant women and puerpera

作　　者：游津 杨弋[2,3] 黄燕[1,3] YOU Jin;YANG Yi;HUANG Yan(West China School of Nursing,Sichuan University/West China Second University Hospital,Sichuan University,Sichuan 610065 China)

机构地区：[1]四川大学华西护理学院/四川大学华西第二医院,四川610065 [2]四川大学华西第二医院 [3]出生缺陷与相关妇儿疾病教育部重点实验室

出　　处：《护理研究》2022年第14期2481-2485,共5页Chinese Nursing Research

基　　金：四川省卫生健康委员会科研课题,编号:20PJ079。

摘　　要：目的:评估改良产科早期预警系统(MEOWS)在孕产妇中的应用效果。方法:选取2020年4月—2020年5月某三级甲等妇女儿童医院产科收治的2800例孕产妇作为研究对象,采用MEOWS对孕产妇住院期间的异常生理参数进行红黄警报评估,根据出院时的疾病诊断判定危重孕产妇,在此基础上评价MEOWS的预测效果。结果:829例(29.6%)孕产妇触发MEOWS,144例孕产妇符合危重孕产妇的标准。对危重孕产妇预测的总体灵敏度为83.3%[95%CI(76.2%,89.0%)],特异度为73.3%[95%CI(71.6%,75.0%)],阳性预测值为14.5%[95%CI(12.2%,17.0%)],阴性预测值为98.8%[95%CI(98.2%,99.2%)]。以危重孕产妇为对象时,MEOWS的受试者工作特征曲线下面积为0.783[95%CI(0.746,0.820)]。结论:MEOWS能够为早期识别危重孕产妇的病情变化提供参考,但其预测危重孕产妇的阳性预测值还有待进一步提高。Objective:To evaluate effect of Modified Early Obstetric Warning System(MEOWS)in pregnant women and puerpera.Methods:2800 pregnant women and puerpera admitted to the obstetrics department of a tertiary grade A women and children's hospital from April 2020 to may 2020 were selected as subjects.MEOWS was used to evaluate for red and yellow alarm through abnormal physiological parameters of pregnant women and puerpera during hospitalization.Critical pregnant women and puerpera were determined according to disease diagnosis at discharge.On this basis,the predictive effect of MEOWS was evaluated.Results:829 pregnant women and puerpera(29.6%)triggered MEOWS,and 144 pregnant women and puerpera met criteria for critical pregnant women and puerpera.The overall sensitivity of critical pregnant women and puerpera prediction was 83.3%[95%CI(76.2%,89.0%)],the specificity was 73.3%[95%CI(71.6%,75.0%)],the positive predictive value was 14.5%[95%CI(12.2%,17.0%)],and the negative predictive value was 98.8%[95%CI(98.2%,99.2%)].When took critical pregnant women and puerpera as subjects,area under the curve of the receiver operating characteristic of MEOWS was 0.783[95%CI(0.746,0.820)].Conclusions:MEOWS can provide reference for early identification of condition changes of critical pregnant women and puerpera,but its positive predictive value for critical pregnant women and puerpera needs to be further improved.

关 键 词：改良产科早期预警系统 危重症 孕妇 产妇 护理 

分 类 号：R473.71[医药卫生—护理学]