改良早期预警评分与急性胃肠损伤分级对急性酒精中毒严重程度及预后的研究

Application of MEWS and AGI classification in acute alcohol intoxication treat and cure

目的探讨改良早期预警评分(MEWS)与急性胃肠损伤(AGI)分级在急性酒精中毒救治中的应用价值。方法收集80例急性酒精中毒患者的病历资料,记录患者的意识状态及临床指标,包括体温、呼吸频率、心率、收缩压,以及患者的消化道症状,应用MEWS及AGI分级进行分析。结果 (1)急性酒精中毒患者的预后:轻度中毒组与中度中毒组相比,年龄(34. 34±14. 18)、恢复情况(1. 00±0. 00)、MEWS(2. 6±1. 52)、AGI分级(1. 00±0. 00)有显著差异(P <0. 05);重度中毒组的恢复情况(1. 33±0. 97)、AGI分级(2. 71±0. 46)与中度中毒组相比,也有显著差异(P <0. 05)。(2)急性酒精中毒患者的AGI分级:与AGIⅡ级相比,AGIⅠ级的年龄(34. 83±14. 88)、恢复情况(1. 03±0. 17)、MEWS(2. 67±1. 55)、严重程度(1. 03±0. 17)有显著差异(P <0. 01),AGIⅢ级的恢复情况(1. 00±1. 03)、严重程度(2. 94±0. 25)有显著差异(P <0. 01);与AGIⅢ级相比,AGIⅠ级的年龄(46. 21±11. 41)、MEWS(4. 54±2. 29)有显著差异(P <0. 01)。(3)急性酒精中毒患者的MEWS评分:与MEWS≥5分组及MEWS> 9分组相比,MEWS <5分组的AGI分级(1. 54±0. 73)、严重程度(1. 54±0. 73)有显著差异(P <0. 01)。(4) COX回归分析显示,AGI分级与急性酒精中毒患者严重程度呈正相关。结论 MEWS与AGI分级联合使用可以有效评估急性酒精中毒患者病情严重程度及预后。

Objective This paper aims to study the value of application of Modified Early Warning Score( MEWS)and Acute Gastrointestinal Injury( AGI) classification in acute alcohol intoxication treatment. Methods We collected the data of 80 patients who had alcohol intoxication and recorded their state of consciousness and clinic indicators which include body temperature,respiratory rate,heart rate,systolic pressure and digestive symptoms. We did the analysis by using MEWS and AGI classification. Results The results were as follows:( 1) the prognosis of patients with acute alcohol intoxication showed that there existed significant differences( P < 0. 05) in age( 34. 34 ±14. 18),recovery( 1. 00 ± 0. 00),MEWS( 2. 6 ± 1. 52),and AGI grading( 1. 00 ± 0. 00) between the mild poisoning group and the moderate one. Compared with moderate group,the recovery of severe group( 1. 33 ± 0. 97)and AGI classification( 2. 71 ± 0. 46) were also different( P < 0. 05).( 2) AGI classification of patients with acute alcoholism suggested that compared with AGI grade Ⅱ,AGI grade Ⅰ age( 34. 83 ± 14. 88),recovery( 1. 03 ± 0.17),MEWS( 2. 67 ± 1. 55),and severity( 1. 03 ± 0. 17) were significantly different( P < 0. 01). There was a significant difference in recovery( 1. 00 ± 1. 03) and severity( 2. 94 ± 0. 25) in AGI grade Ⅲ( P < 0. 01). Compared with AGI grade Ⅲ,AGI grade Ⅰ age( 46. 21 ± 11. 41) and MEWS( 4. 54 ± 2. 29) were significantly different( P< 0. 01).( 3) MEWS scores of patients with acute alcoholism: Compared with MEWS ≥5 group and MEWS > 9 group,there was a significant difference in AGI grade( 1. 54 ± 0. 73) and severity( 1. 54 ± 0. 73) in MEWS < 5 group( P < 0. 01).( 4) COX regression analysis showed that the AGI grade was positively correlated with the severity of acute alcoholism. Conclusion MEWS score and AGI degree can be used to evaluate the severity and prognosis of patients with acute alcohol intoxication.