增强CT联合MEWS评分对肠系膜损伤的诊断及预后预测价值研究

Study on the Diagnostic and Prognostic Predictive Value of Enhanced CT Combined with MEWS Score for Mesenteric Injury

目的分析增强CT联合MEWS评分对肠系膜损伤的诊断准确率,评估其对预测预后的价值。方法在2018年1月-2022年12月至我院进行肠系膜损伤的患者中随机选择90例进行回顾性研究。所有患者来诊后均予以增强CT检查和NEWS评分。比较增强CT、MEWS评分以及二者联合应用诊断肠系膜损伤的准确率和漏诊率。比较不同MEWS评分患者的预后。包括患者的住院时间,ICU住院时间机械通气时间、并发症发生率。结果增强CT、MEWS评分单独应用诊断肠系膜损伤的准确率分布为63.33%和36.67%,均明显低于二者联合检测的准确率86.67%,且具有统计学差异(P<0.05)。MEWS评分>9分患者的住院时间、ICU住院时间以及机械通气时间长度均超过评分≤9分的患者,且具有统计学差异(P<0.05),MEWS评分>9分共计发生9例并发症,发生率为27.27%,明显高于评分≤9分患者的4例,7.02%,且具有统计学差异(P<0.05)。结论增强CT联合MEWS评分能够明显增加肠系膜损伤的诊断准确率,降低漏诊率,而且NEWS评分对于预测患者预后具有重要的指导价值。

Objective To analyze the diagnostic accuracy of enhanced CT combined with MEWS score on mesenteric injury and assess its value in predicting prognosis.Methods A retrospective study was conducted in 90 randomly selected patients who came to our hospital for mesenteric injury from January 2018 to December 2022.All patients were given an enhanced CT examination and NEWS score upon presentation.To compare the accuracy and leakage rate of enhanced CT,MEWS score and the combination of the two in the diagnosis of mesenteric injury.To compare the prognosis of patients with different MEWS scores.This includes the length of stay of patients,the length of ICU stay mechanical ventilation,and the rate of complications.Results The accuracy distribution of enhanced CT and MEWS score applied alone to diagnose mesenteric injury was 63.33%and 36.67%,both significantly lower than the accuracy of 86.67%for the combined test of both,and statistically different(P<0.05).the length of hospital stay,ICU stay,and length of mechanical ventilation in patients with MEWS score>9 exceeded those with score≤9 and were statistically different(P<0.05).A total of 9 complications occurred in patients with MEWS score>9,with an incidence rate of 27.27%,which was significantly higher than the 4 cases in patients with score≤9,7.02%,and statistically different(P<0.05).Conclusion Enhanced CT combined with MEWS score can significantly increase the diagnostic accuracy of mesenteric injury and reduce the rate of missed diagnosis,and the NEWS score has important guiding value for predicting patient prognosis.