MEWS与APACHEⅡ评分系统在多发伤分诊中的对比研究

Comparative analysis of NEWS scoring system and APACHEⅡ scoring system in separating patients with multiple trauma

目的探讨MEWS与APACHEⅡ两种评分系统对急诊多发伤患者病情评估的可行性。方法对我科68例急诊多发伤患者分别进行MEWS与APACHEⅡ评分,对患者病情与APACHEⅡ与MEWS评分的关系进行分析,并对患者不同预后的APACHEⅡ与MEWS评分进行比较。结果急诊留观患者的的MEWS与APACHEⅡ评分最低,接着为收治专科病房与收治ICU的患者,行立刻抢救患者的MEWS与APACHEⅡ评分为最高;存活患者的APACHEⅡ与MEWS评分均明显低于死亡患者的评分,组间比较,差异有统计学意义(P<0.05);两种评分方法对患者预后的预测能力等同,组间比较,差异无统计学意义(P>0.05)。结论MEWS与APACHEⅡ评分系统应用于急诊多发伤患者均可行,MEWS与APACHEⅡ评分与患者的伤情密切相关,评分越高患者伤情越重,分数越高死亡的可能性也就越高。

Objective To explore feasibility of NEWS scoring system and APACHE Ⅱ scoring system in assessment of disease conditions of patients with multiple trauma in emergency department. Methods 68 patients with multiple trauma in emergency department were scored by NEWS scoring system and APACHE Ⅱ scoring system. Correlations between disease conditions of patients and scores of NEWS scoring system and APACHE Ⅱ scoring system were analyzed. In addition, different prognostic APACHE Ⅱ scoring and NEWS scoring were compared. Results NEWS and APACHE Ⅱ scores of patients in the emergency department were the lowest, followed by patients admitted by HDU and ICU. NEWS and APACHE Ⅱ scores of patients who received immediate rescue were the highest. NEWS and APACHE Ⅱ scores of survived patients were both significantly lower than those of dead patients（P〈0.05）. Two scoring systems had equal prediction ability to predict prognosis of patients（P〈0.05）. Conclusion It is feasible to apply NEWS scoring system and APACHE Ⅱ scoring system to patients with multiple trauma in emergency department. NEWS and APACHE Ⅱ scores are closely related to disease conditions of patients. Higher score equals to worse disease conditions and more possibility of death.