PEWS、NEWS、NCIS在新生儿败血症病情评估中的预测价值研究

Study on the Predictive Value of PEWS, NEWS and NCIS in the Evaluation of Neonatal Septicemia

目的:探讨新生儿早期预警评分(newborn early warning score,NEWS)、儿童早期预警评分(pediatric early warning score,PEWS)、新生儿危重病例评分(neonatal critical illness score,NCIS)在新生儿败血症(neonatal sepsis)病情评估中的价值。方法:选取2017年12月-2018年12月在本院接受治疗的180例新生儿败血症患儿作为研究对象,根据患儿的临床表现将其分为非重症组(103例)和重症组(77例)。比较两组患儿的基本资料、PEWS评分、NEWS评分、NCIS评分和入住ICU的时间。采用受试者工作特征(receiver operating characteristic,ROC)曲线对三种评分系统在新生儿败血症患儿预后评价中的效能进行分析。结果:重症组与非重症组患儿性别构成、胎龄、产龄比较,差异均无统计学意义(P>0.05),重症组患儿入住ICU时间显著短于对照组,PEWS、NEWS评分均显著高于非重症组,NCIS评分显著低于非重症组,差异均有统计学意义(P<0.05)。三种评分评估新生儿败血症患儿预后ROC曲线下面积(AUC)比较,差异无统计学意义(P>0.05),PEWS、NEWS、NCIS评分的约登指数分别为0.552、0.549和0.698。结论:PEWS、NEWS、NCIS三种早期预警评分系统在评估新生儿败血症病情变化、预后评估等方面效果较好,能准确反映出患儿病情的严重程度,应用简单,值得临床推广应用。

Objective:To explore the value of NEWS,PEWS,NCIS in the assessment of neonatal sepsis.Method:A total of 180 children with neonatal septicemia who received treatment in our hospital from December 2017 to December 2018 were selected as the study subjects,according to their clinical manifestations,the children were divided into non-severe group(103 cases)and severe group(77 cases).Basic data,PEWS score,NEWS score,NCIS score and length of stay in ICU were compared between the two groups.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of three scoring systems in the prognostic evaluation of children with neonatal sepsis.Result:There was no significant difference in sex composition,gestational age and delivery age between the severe group and the non-severe group(P>0.05).The ICU stay time of the severe group was significantly shorter than that of the non-severe group,PEWS and NEWS scores were significantly higher than those of the non-severe group,and NCIS scores was significantly lower than that of the non-severe group,the differences were statistically significant(P<0.05).There was no significant difference in AUC among the three scores(P>0.05),the Yoden index of PEWS,NEWS and NICS were 0.552,0.549 and 0.698,respectively.Conclusion:PEWS,NEWS and NCIS are effective in evaluating the prognosis and prognosis of neonatal sepsis,and can accurately reflect the severity of the disease in children.They are simple in application and worthy of clinical application.