中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
24期
11392-11395
,共4页
朱睿瑶%姚兰%夏文芳%张迪%邹捍东%周青山
硃睿瑤%姚蘭%夏文芳%張迪%鄒捍東%週青山
주예요%요란%하문방%장적%추한동%주청산
多处创伤%预后%急性病生理学和长期健康评价%改良早期预警评分
多處創傷%預後%急性病生理學和長期健康評價%改良早期預警評分
다처창상%예후%급성병생이학화장기건강평개%개량조기예경평분
Multiple trauma%Prognosis%APACHE%Modified early warning score
目的：探讨改良早期预警评分（MEWS）和急性生理学及慢性健康状况评估Ⅱ（APACHEⅡ）评分系统在ICU多发伤患者预后判断的价值。方法回顾性分析2011年11月至2013年8月入住我院ICU中的118例多发伤患者的临床资料，按预后分为死亡组和存活组，入院后分别进行MEWS评分及APACHEⅡ评分，比较死亡组和存活组 MEWS 评分和 APACHEⅡ评分的差别，应用受试者工作特征（ROC）曲线分析方法，对两种评分方法评估多发伤患者预后不良的价值进行分析。结果死亡组 MEWS 评分和APACHEⅡ评分均大于存活组，差异有统计学意义（P＜0.01），MEWS 评分和 APACHEⅡ评分受试者工作特征曲线（ROC）下面积分别为0.936和0.926，两种评分的曲线下面积差异无统计学意义（P＞0.05），均有较强预测价值。以死亡为预测目标时，MEWS 的最佳截断点分值为8，APACHEⅡ评分最佳截断点为19。结论 MEWS 评分对多发伤患者预后判断与 APACHEⅡ评分具有同等预测价值，但 MEWS 评分比APACHEⅡ评分操作更简易，获取数据方便，节省时间及费用，故在多发伤患者入院后病情及预后评估中值得推广应用。
目的：探討改良早期預警評分（MEWS）和急性生理學及慢性健康狀況評估Ⅱ（APACHEⅡ）評分繫統在ICU多髮傷患者預後判斷的價值。方法迴顧性分析2011年11月至2013年8月入住我院ICU中的118例多髮傷患者的臨床資料，按預後分為死亡組和存活組，入院後分彆進行MEWS評分及APACHEⅡ評分，比較死亡組和存活組 MEWS 評分和 APACHEⅡ評分的差彆，應用受試者工作特徵（ROC）麯線分析方法，對兩種評分方法評估多髮傷患者預後不良的價值進行分析。結果死亡組 MEWS 評分和APACHEⅡ評分均大于存活組，差異有統計學意義（P＜0.01），MEWS 評分和 APACHEⅡ評分受試者工作特徵麯線（ROC）下麵積分彆為0.936和0.926，兩種評分的麯線下麵積差異無統計學意義（P＞0.05），均有較彊預測價值。以死亡為預測目標時，MEWS 的最佳截斷點分值為8，APACHEⅡ評分最佳截斷點為19。結論 MEWS 評分對多髮傷患者預後判斷與 APACHEⅡ評分具有同等預測價值，但 MEWS 評分比APACHEⅡ評分操作更簡易，穫取數據方便，節省時間及費用，故在多髮傷患者入院後病情及預後評估中值得推廣應用。
목적：탐토개량조기예경평분（MEWS）화급성생이학급만성건강상황평고Ⅱ（APACHEⅡ）평분계통재ICU다발상환자예후판단적개치。방법회고성분석2011년11월지2013년8월입주아원ICU중적118례다발상환자적림상자료，안예후분위사망조화존활조，입원후분별진행MEWS평분급APACHEⅡ평분，비교사망조화존활조 MEWS 평분화 APACHEⅡ평분적차별，응용수시자공작특정（ROC）곡선분석방법，대량충평분방법평고다발상환자예후불량적개치진행분석。결과사망조 MEWS 평분화APACHEⅡ평분균대우존활조，차이유통계학의의（P＜0.01），MEWS 평분화 APACHEⅡ평분수시자공작특정곡선（ROC）하면적분별위0.936화0.926，량충평분적곡선하면적차이무통계학의의（P＞0.05），균유교강예측개치。이사망위예측목표시，MEWS 적최가절단점분치위8，APACHEⅡ평분최가절단점위19。결론 MEWS 평분대다발상환자예후판단여 APACHEⅡ평분구유동등예측개치，단 MEWS 평분비APACHEⅡ평분조작경간역，획취수거방편，절성시간급비용，고재다발상환자입원후병정급예후평고중치득추엄응용。
Objective To study the assessment value of Modified Early Warning Score (MEWS) and Acute Physiology and Chronic Health Evaluation (APACHEⅡ) score for the prognosis of multiple trauma patients in intensive care unit. Methods The clinical data of 118 patients with multiple trauma, admitted from November 2011 to August 2013 in intensive care unit (ICU), were retrospectively analyzed. Patients were divided into two groups: the death group and the survival group according to prognosis. Death group and survival group MEWS score and APACHEⅡ score were calculated for them and the differences were compared between the two groups. The difference of the area under receiver operating characteristic curve were compared between MEWS score and APACHEⅡ score to analysis the assessment value in prognosis of multiple trauma patients. Results APACHEⅡ and MEWS score in the death group respectively, significantly higher than those in the survival group (P<0.01). The area under receiver operating characteristic (ROC) curves of APACHEⅡ and MEWS scores were 0.936 and 0.926. They all show strong intensity of forecasting value. When we chose the death as the forecast index, the cut-off of MEWS grade was 8 and the cut-off of APACHEⅡ grade was 19. Conclusion For multiple trauma patients, the prognosis value of MEWS and APACHEⅡ score is similar, while MEWS is simpler, faster, more convenient, and own the advantage of time-saving as well as economical, which should be extended in clinical practice in prognosis assessment of multiple trauma patients.
