中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (2): 146-150.doi: 10.19438/j.cjoms.2021.02.009

• 论著 • 上一篇    下一篇

2种早期预警评分方法对牙源性下行性坏死性纵隔感染患者病情及风险的评估比较

李莉1,2, 沈萍1,2, 季萍萍3, 杨志胤2,*, 侯黎莉1,*   

  1. 1.上海交通大学医学院附属第九人民医院 护理部,
    2.胸外科,上海 200011;
    3.上海交通大学 护理学院,上海 200011
  • 收稿日期:2020-08-26 修回日期:2020-11-13 出版日期:2021-03-20 发布日期:2021-05-11
  • 通讯作者: 杨志胤,E-mail:611621@sh9hospital.org.cn;侯黎莉,E-mail: 217008@sh9hospital.org.cn。*共同通信作者
  • 作者简介:李莉（1976-）,女,本科,主管护师, E-mail:madheadnurse@163.com
  • 基金资助:
    上海交通大学医学院附属第九人民医院院级护理基金项目（JYHL2019MS05）

Comparison of two early warning scoring methods in evaluating the condition and risk of patients with odontogenic descending necrotizing mediastinitis

LI Li1,2, SHEN Ping1,2, JI Ping-ping3, YANG Zhi-yang2, HOU Li-li1   

  1. 1. Nursing Department,
    2. Department of Thoracic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
    3. Shanghai Jiao Tong University School of Nursing. Shanghai 200011, China
  • Received:2020-08-26 Revised:2020-11-13 Online:2021-03-20 Published:2021-05-11

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摘要： 目的 比较改良早期预警评分（modified early warning score,MEWS）与修正MEWS在下行性坏死性纵隔感染患者中的应用价值。方法 回顾性分析上海交通大学医学院附属第九人民医院胸外科2018年7月—2019年12月收治的65例下行性坏死性纵隔感染患者的临床资料,以患者是否发展为重症作为观察指标,分别用MEWS与修正MEWS对患者进行评估,比较2种评分方法评估患者疾病严重程度及预后的灵敏度及特异度。采用SPSS 22.0软件包对数据进行统计学分析。结果 2种评分表在对患者疾病严重程度的预测能力上均具有中等程度的分辨度,修正MEWS评分显著高于MEWS评分（Z=2.257,P=0.024）,MEWS的ROC曲线下面积为0.669（95%CI：0.538~0.800,P=0.023）,修正MEWS的ROC曲线下面积为0.818（95%CI：0.718~0.917,P=0.000）。结论 修正MEWS能更有效地反映患者入院时病情危重程度,有利于医护人员早期发现患者潜在的病情风险,及时做好应急处置,保证护理安全,具有重要的临床意义。

关键词: 下行性坏死性纵隔炎, 改良早期预警评分, 修正改良早期预警评分, 预警评分值

Abstract: PURPOSE: To compare the application value of modified early warning score (MEWS) and corrected MEWS in patients with descending necrotizing mediastinitis. METHODS: A retrospective analysis of the clinical data of 65 patients with descending necrotizing mediastinitis treated from July 2018 to December 2019 was performed, and whether the patient developed severe disease was used as the observation index. The patients were evaluated with MEWS and corrected MEWS respectively, and the sensitivity and specificity of the two scoring methods to assess the severity of disease and prognosis were compared. SPSS 22.0 software package was used for statistical analysis. RESULTS: Both scoring scales had a moderate degree of resolution in predicting the severity of the patient's disease, the corrected MEWS score was significantly higher than the MEWS score (Z=2.257, P=0.024), the area under the ROC curve of MEWS was 0.669 (95% CI: 0.538-0.800, P=0.023), and the area under the ROC curve of the corrected MEWS was 0.818 (95% CI: 0.718-0.917, P=0.000). CONCLUSIONS: The corrected MEWS scoring can more effectively reflect the severity of the patient's condition at the time of admission, which is helpful for nurses to find out the potential disease risk of patients in the early stage, do a good job in emergency treatment in time, thus having important clinical significance for improving the safety of patients' medical care.

Key words: Descending necrotizing mediastinitis, Modified early warning score, Corrected modified early warning score, Early warning score value

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