中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
24期
46-49
,共4页
谢宜%陈雪枝%苏奕强%郑瑞琪%陈雪华%蔡妙凤
謝宜%陳雪枝%囌奕彊%鄭瑞琪%陳雪華%蔡妙鳳
사의%진설지%소혁강%정서기%진설화%채묘봉
改良早期预警评分%院前急救%病情评估%应用
改良早期預警評分%院前急救%病情評估%應用
개량조기예경평분%원전급구%병정평고%응용
Modified early warning score%Pre hospital first aid%Disease evaluation%Application
目的 探讨改良早期预警评分(MEWS)方法在院前急救中对患者病情评诂的应用价值.方法 对3 478例院前急救患者采用现场MEWS方法,评分分为0～4分、5～9分和≥10分.分析不同分数段患者的分布特点与病情的关系,并追踪患者入院后的去向及病情转归.结果 院前急救患者中MEWS以低分0～4分为主,占69.18％(2 406/3 478),重症患者仅占2.58％(62/2 406);MEWS 5～9分占21.54％ (749/3 478),重症患者增加到37.92％ (284/749);MEWS≥10分仅占9.29％ (323/3 478),重症患者增加到87.00％(281/323).MEWS分数段越高,重症患者的比率就越高,MEWS 5～9分及≥10分的重症患者比率与MEWS0～4分重症患者比率差异有统计学意义(P值均＜ 0.01).MEWS 5～9分及≥10分患者入院后收住专科病房和重症监护病房治疗的比率较MEWS0～4分患者明显增加(P值均＜0.01),病死率也显著增加,差异有统计学意义(P值均＜0.01).结论 MEWS方法在院前急救中能早期预警潜在危重症的患者,评分分数段越高,病情越严重,病死率越高.
目的 探討改良早期預警評分(MEWS)方法在院前急救中對患者病情評詁的應用價值.方法 對3 478例院前急救患者採用現場MEWS方法,評分分為0～4分、5～9分和≥10分.分析不同分數段患者的分佈特點與病情的關繫,併追蹤患者入院後的去嚮及病情轉歸.結果 院前急救患者中MEWS以低分0～4分為主,佔69.18％(2 406/3 478),重癥患者僅佔2.58％(62/2 406);MEWS 5～9分佔21.54％ (749/3 478),重癥患者增加到37.92％ (284/749);MEWS≥10分僅佔9.29％ (323/3 478),重癥患者增加到87.00％(281/323).MEWS分數段越高,重癥患者的比率就越高,MEWS 5～9分及≥10分的重癥患者比率與MEWS0～4分重癥患者比率差異有統計學意義(P值均＜ 0.01).MEWS 5～9分及≥10分患者入院後收住專科病房和重癥鑑護病房治療的比率較MEWS0～4分患者明顯增加(P值均＜0.01),病死率也顯著增加,差異有統計學意義(P值均＜0.01).結論 MEWS方法在院前急救中能早期預警潛在危重癥的患者,評分分數段越高,病情越嚴重,病死率越高.
목적 탐토개량조기예경평분(MEWS)방법재원전급구중대환자병정평고적응용개치.방법 대3 478례원전급구환자채용현장MEWS방법,평분분위0～4분、5～9분화≥10분.분석불동분수단환자적분포특점여병정적관계,병추종환자입원후적거향급병정전귀.결과 원전급구환자중MEWS이저분0～4분위주,점69.18％(2 406/3 478),중증환자부점2.58％(62/2 406);MEWS 5～9분점21.54％ (749/3 478),중증환자증가도37.92％ (284/749);MEWS≥10분부점9.29％ (323/3 478),중증환자증가도87.00％(281/323).MEWS분수단월고,중증환자적비솔취월고,MEWS 5～9분급≥10분적중증환자비솔여MEWS0～4분중증환자비솔차이유통계학의의(P치균＜ 0.01).MEWS 5～9분급≥10분환자입원후수주전과병방화중증감호병방치료적비솔교MEWS0～4분환자명현증가(P치균＜0.01),병사솔야현저증가,차이유통계학의의(P치균＜0.01).결론 MEWS방법재원전급구중능조기예경잠재위중증적환자,평분분수단월고,병정월엄중,병사솔월고.
Objective To investigate the application value of modified early warning score (MEWS) for assessment of patients in pre hospital first aid.Methods For patients with MEWS method in 3 478 cases of pre hospital first aid,scored in 0-4,5-9 and ≥ 10 points.Analysis of the relationship between the distribution and severity in patients with different grades,and tracing the fate and the condition of patients after admission.Results In MEWS patients with low 0-4 points was divided into pre hospital first aid,accounted for 69.18％ (2 406/3 478),severe cases accounted for 2.58％ (62/2 406); MEWS 5-9 accounted for 21.54％ (749/3 478),severe patients increased to 37.92％ (284/749); MEWS ≥ 10 points accounted for only 9.29％ (323/3 478),severe patients increased to 87.00％ (281/323).MEWS scores higher ratio in patients with severe more,MEWS 5-9 points,severe patients with MEWS ≥ 10 points 0-4 critical patients proportion (P ＜ 0.01).MEWS 5-9 points,≥ 10 points patients admitted to a specialist ward and intensive care units treatment compared with MEWS 0-4 points patients increased significandy (P ＜ 0.01),the mortality rate was also significandy increased (P ＜ 0.01).Conclusion The MEWS method in pre hospital first aid to early warning of potential in critically ill patients,the higher score,the more serious condition,the higher mortality rate.
