MEWS联合疼痛评分在肝胆外科急危重症患者病情预警中的应用  

Application of MEWS combined with pain assessment in early warning of acute and severe patients in hepatobiliary surgery

作　　者：黄银英 李春容 林少虹 林月双 HUANG Yin-ying;LI Chun-rong;LIN Shao-hong(Department of Hepatobiliary Surgery,The Eighth Clinical Medical College of Guangxi Medical University,Guigang People's Hospital,Guigang 537100,China;Nursing department,The Eighth Clinical Medical College of Guangxi Medical University,Guigang People's Hospital,Guigang 537100,China)

机构地区：[1]广西医科大学第八临床医学院贵港市人民医院肝胆外科,广西贵港537100 [2]广西医科大学第八临床医学院贵港市人民医院护理部,广西贵港537100

出　　处：《吉林医学》2023年第10期2942-2945,共4页Jilin Medical Journal

基　　金：贵港市科学研究与技术开发计划基金项目[项目编号:贵科攻1513011]。

摘　　要：目的:探讨自认预警评分(MEWS)联合疼痛视觉模拟评分(VAS)在肝胆外科急危重症患者病情早期预警中的应用效果。方法:选取232例肝胆外科急危重症患者为研究对象,按住院时间先后分为对照组与观察组各116例,对照组以常规方法观察患者意识、体温、心率、呼吸、血压及是否出现症状体征变化、是否存在疼痛,并及时与值班医生沟通处理。观察组应用MEWS病情自动预警系统计算MEWS分值,并进行VAS评分,结合症状体征变化进行综合判断并及时与值班医生沟通处理。比较两组护士评估病情时间、处置患者速度、患者及医生对护士观察病情的工作满意度;并分析观察组MEWS预警等级与疼痛程度的相关性。结果:观察组评估病情时间、处置患者的速度与对照组比较,差异均有统计学意义(P<0.05);观察组患者及医生对护士工作满意度高于对照组,差异均有统计学意义(P<0.05);观察组MEWS预警等级与疼痛程度存在正相关(r=0.916,P<0.05)。结论:将MEWS及VAS评分联合应用于肝胆外科急危重症患者病情观察,能有效缩短护士评估病情的时间,提高护士处置速度和患者及医生对护理工作满意度,对肝胆外科急危重症患者病情观察起到早期预警作用。Objective To investigate the effect of MEWS combined with visual analogue pain scale(VAS)in early warning of acute and severe patients in hepatobiliary surgery.Method A total of 232 patients in liver and gallbladder surgery were selected as the research subjects,they were divided into the control group and the observation group according to their hospitalization time.116 patients in each group.The control group was observed by conventional methods in terms of con-sciousness,body temperature,heart rate,respiration,blood pressure,symptoms,signs and pain,and communicated with the doctors on duty in time.The observation group used MEWS automatic warning system to calculate MEWS score and VAS score,combined with the changes of symptoms and signs to make a comprehensive judgment and timely communicate with the doctor on duty.The two groups were compared in terms of the time for nurses to evaluate the illness,the speed of handling patients,and the satisfaction of patients and doctors with the nurse's observation of the illness.The correlation between MEWS warning level and pain degree in the observation group was analyzed.Results There was a statistically significant difference in the evaluation time and speed of patient treatment between the observation group and the control group(P<0.05);The job satisfaction of patients and doctors in the observation group was higher than that in the control group(P<0.05);Observation group:MEWS warning level was correlated with pain degree(r=0.916,P<0.05).Conclusion The combined application of MEWS and VAS score to the observation of acute and critical patients in hepatobiliary surgery can effectively shorten the time for nurses to evaluate the condition,improve the speed of nurses'treatment and the satisfaction of patients and doctors to nursing work,and play an early warning role in the observation of acute and critical patients in hepatobiliary surgery.

关 键 词：自动预警评分 视觉疼痛评分 早期预警 

分 类 号：R473.6[医药卫生—护理学]