早期预警评分在严重创伤失血性休克患者急诊护理中应用研究

The Application of Early Warning Score in Emergency Nursing of Patients with Severe Traumatic Hemorrhagic Shock

目的早期预警评分（MEWS）在严重创伤失血性休克患者急诊护理中应用研究。方法方便选取该院2014年3月—2015年3月收治的90例严重创伤失血性休克患者为研究对象,从现场采集相关的研究数据,并进行MEWS评价,依据MEWS将患者分为3组,A组（75例）MEWS为0-3分,B组（12例）MEWS为4-6分,C组（3例）MEWS为7-11分,观察终点为入院后1个月。比较3组患者去向（离院、留院观察、入专科病房、入ICU）及预后;依据患者预后分为死亡组与生存组,记录死亡组与生存组MEWS。结果 A组入ICU的患者占13.33%,B组占5.33%,C组占66.67%,3组两两比较差异有统计学意义（P〈0.05）。MEWS越高,患者入ICU的比例越高,病情越严重。C组死亡率高于A、B组,差异有统计学意义（P〈0.05）。MEWS越高,患者死亡率越高。死亡组MEWS（5.25±1.10）分高于对照组（2.13±1.05）分,差异有统计学意义（P〈0.05）。结论 MEWS用于严重创伤失血性休克患者的急诊护理,可较好的评估患者病情,依据评估情况采取有效的干预措施,使抢救成功率提高,从而可降低患者致残率、致死率,具有较好的临床应用价值。

Objective Application of early warning score（MEWS） in emergency care of patients with severe traumatic hemorrhagic shock. Methods Convenient selection our hospital from March 2014 to March 2015, 90 cases of severe traumatic hemorrhagic shock patients as the research object, collecting relevant data from the scene, and evaluation of MEWS based on MEWS, the patients were divided into 3 groups, A group（75 cases） MEWS was 0~3 point, B group（12 cases） MEWS was 4 ~6 point, C group（3 cases） MEWS was 7 ~11 point, the endpoint was 1 months after admission. The fate of three groups of patients（from the hospital, stay in hospital observation, into the special wards, into the ICU） and prognosis; according to the prognosis of patients were divided into death group and survival group, record the death group and survival group MEWS. Results A group of patients with ICU accounted for 13.33%, B group accounted for 5.33%, C group was66.67%, three group of 22 was statistically significant（P〈0.05）. The higher the MEWS, the higher the proportion of patients into the ICU, the more severe the disease. The mortality rate of A group was higher than that of B and C group, and there was statistical significance（P〈0.05）. The higher the MEWS, the higher the mortality rate of the patients. MEWS（5.25±1.10）point in the death group was higher than that in the control group（2.13±1.05）point, with statistical significance（P〈0.05）.Conclusion MEWS for severe traumatic hemorrhagic shock patients in emergency nursing, can better assess the patient, according to the appraisal situation take effective intervention measures to improve the success rate of rescue, which can decrease the disability rate and death rate, and has good clinical application value.