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目的:探讨改良早期预警评分(MEWS)和急性生理和慢性健康状况评估Ⅱ(APACHEⅡ)对急诊室患者病情的评估,分析临床可行性。方法:回顾性分析2012-04-2015-04入住我院急诊室的118例患者资料,死亡组31例,存活组87例。入院后,用MEWS评分评估患者的临床一般指标(包括心率、呼吸、体温、血压、意识);APACHEⅡ评分针对年龄(≥18岁)、急性生理病理改变和慢性健康情况3个方面评估。对2组患者的MEWS及APACHEⅡ评分进行比较;比较2组不同等级的MEWS评分对患者病死率和APACHEⅡ评分的影响;探讨两种评分方案的相关性、敏感度及预后。结果:死亡组患者在两种评分方案中得分均高于存活组(P<0.01);并且随着MEWS评分增高,病死率随之升高,同时APACHEⅡ评分也随之升高,且两种评分之间呈正性相关;两种评分在判断患者预后方面均具有统计学意义(P<0.05),但两种评分之间比较差异无统计学意义(P>0.05);MEWS评分与APACHEⅡ评分的敏感度方面差异无统计学意义(P>0.05)。结论:MEWS评分方案对急诊患者具有可靠性强、操作方便、检测速度快,值得在临床中推广使用。
Objective: To investigate the assessment of the condition of emergency room patients by Modified Early Warning Scale (MEWS) and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), and analyze the clinical feasibility. Methods: A retrospective analysis of 118 patients admitted to our emergency department from 2012-04-2015-04 included 31 deaths and 87 survivors. After admission, the MEWS score was used to evaluate the general clinical parameters (including heart rate, respiration, body temperature, blood pressure, consciousness). The APACHEⅡscore was evaluated in terms of age (≥18 years), acute physiology and pathology and chronic health condition. The MEWS and APACHEⅡscores of two groups of patients were compared. The effects of different grades of MEWS scores on the patients’ mortality and APACHEⅡscore were compared. The correlation, sensitivity and prognosis of the two scoring schemes were compared. Results: The scores of patients in the death group were higher than those in the survival group (P <0.01). And with the increase of MEWS score, the mortality rate increased and the APACHEⅡ score also increased. (P <0.05), but there was no significant difference between the two scores (P> 0.05); MEWS score was positively correlated with APACHEⅡ score Degree differences were not statistically significant (P> 0.05). Conclusion: The MEWS score scheme has strong reliability, easy operation and fast detection for emergency patients, which is worth to be popularized in clinic.