儿童早期预警评分对住院呼吸系统疾病患儿病情判断的有效性

The effectiveness of early warning scores for children in judging the condition of children with respiratory diseases

目的研究儿童早期预警评分(PEWS)对住院呼吸系统疾病患儿病情判断的有效性。方法按标准选取2017年1月至2018年2月在我院儿科治疗的患儿108例,年龄1～13岁,其中男58例,平均年龄(5. 8±3. 9)岁,女50例,平均年龄(6. 1±3. 5岁),所有患儿入院后根据临床表现评估后将患儿分为重症组与非重症组,其中重症组38例,非重症组70例,分组完成后所有患者进行PEWS评分,所有患儿对症治疗,严重者收入我院ICU,记录患儿病情及疾病转归结果。结果重症组与非重症组相比,性别及住院天数不具有统计学意义(P> 0. 05);与重症组相比,非重症组年龄及死亡率均小于重症组,差异具有统计学意义(P <0. 05)。重症组患儿PEWS评分平均(4. 8±2. 3)分,非重症组患者平均(2. 8±1. 0)分,两组患儿相比,非重症组患儿评分明显低于重症组,差异具有统计学意义(P <0. 05)。当PEWS评分为≥3分时,预测患者需要监护,ROC曲线下面积为0. 914,95%CI:0. 897～0. 945,敏感度为0. 719,特异度为0. 956。结论本研究证实PEWS是简单有效的评分系统,在急性呼吸道感染患儿的病情评估以及有效分流中具有准确的指导作用,可成为儿科呼吸系统疾病患儿病情判断的常规评分表。

Objective To study the value of pediatric early warning score（ PEWS） in evaluating the severity and prognosis of respiratory diseases in hospitalized children. Methods 108 children were selected from January 2017 to February 2018 in the pediatric department of our hospital,whose age range from 1 ～ 13 years old,including 58 males with mean age（ 5. 8 ± 3. 9） years old and 50 females with mean age（ 6. 1 ± 3. 5） years old. After all the children were admitted to the hospital,all the doctors of the group underwent joint consultation. According to the clinical performance evaluation,the children were divided into severe and non-critical groups. As a result,38 cases were put into the severe group,while 70 in the non-severe group. All of the children were given symptomatic treatment,while severe cases were assigned into ICU in our hospital. General condition an outcome of the children were recorded. Results There was no significant differences between the groups in gender and hospitalized duration（ P 〉 0. 05）. The mean age and the mortality of patients in non-severe group were lower than that in the severe group（ P 〈 0. 05）. The difference was statistically significant（ P 〈 0.05）. Mean PEWS score of the severe group was higher than that of the non-severe group（ 4. 8 ± 2. 3 vs 2. 8 ± 1. 0,P 〈 0. 05）. The area under the curve of ROC was 0. 914（ 95% CI： 0. 897 ～ 0. 945）,with a sensitivity of 0. 719 and a specificity of 0. 956,while the cutoff point of PEWS score was set at 3. Conclusion This study confirmed that PEWS is a simple and effective scoring system,which give a precise guidance on patient assessment and shunt for the children with acute respiratory tract infection. It deserve to be recommended as a routine scoring table for children in respiratory department.