早期预警评分在急诊科急性胰腺炎患者护理中的应用

Application value of MEWS scoring assessment system in severe acute pancreatitis patients

目的探究早期预警评分在急诊科急性胰腺炎患者护理中的应用效果。方法选择2014年1月~2017年3月首都医科大学附属北京友谊医院急诊科收治的急性重症胰腺炎患者94例,入院时进行MEWS动态评分,根据评分结果采取相应措施,分析MEWS评分结果与患者入院时间、预后之间的关系,比较运用MEWS前后医生、家属满意度。结果 94例患者经治疗无效死亡6例,死亡率为6.38%,死亡组平均MEWS评分高于存活组(P<0.05);入院时不同MEWS评分组间死亡率差异有统计学意义(P<0.05),随着MEWS评分升高,死亡率逐渐升高;不同MEWS评分组间好转率和治愈率差异有统计学意义(P<0.05),0分患者治愈率最高(100.00%),≥6分患者好转率最高(75.00%);经过有效治疗,患者总体MEWS评分逐渐下降,尤其在入院6 h后,下降趋势最为明显。结论 MEWS评分具有方便、快捷、易掌握的特点,可以准确反映SAP患者病情危重程度,对于预测患者预后具有积极意义,并能明显提升患者的护理质量。

Objective To explore the effect of MEWS in the nursing of patients with acute pancreatitis in emergency department.Methods Totally 94 patients admitted in the Emergency Department of Beijing Friendship Hospital,Capital Medical University from January 2014 to March 2017 were evaluated by MEWS,and corresponding measures were taken according to the MEWS scores.Then,the relationship between MEWS scores and admission time,prognosis were analyzed,the satisfaction of nursing job before and after MEWS were compared.Results 6 patients died after treatment among 94 patients,with mortality rate of 6.38%.The average MEWS score of death group was higher than that of survival group,the difference was statistically significant（P〈0.05）.The mortality gradually elevated with the increase of MEWS score,and there were statistically significant differences in cure rate and improvement rate of the patients with different MEWS score（P 0.05）.The cure rate of the patients with 0 point in MEWS score was the highest（100.00%）,and the improvement rate of the patients with MEWS score ≥6 was the highest（75.00%）.Through effective treatment measures,overall MEWS scores gradually declined,especially after 6 hours of admission,the decline was most pronounced.Conclusion MEWS score has the characteristics of convenient,quick and easy to master,can accurately reflect the state of illness and evaluate prognosis of the patients with SAP,also can obviously improve the nursing quality.