妊娠晚期孕妇预警评分的临床预测价值及其对护理指导意义

Clinical prediction value and nursing guiding significance of early warning score for late trimester of pregnant women

目的探讨妊娠晚期孕妇预警评分(EWSLP)的临床预测价值及其对护理工作的指导意义。方法采用前瞻性研究收集2020年2月至2021年8月在中国人民解放军南部战区总医院产检的150例28~32周孕晚期孕妇,并对所有孕妇进行EWSLP评分,根据孕妇妊娠情况的进展将其划分为危重组(n=49)和非危重组(n=101);根据产科风险事件将其划分为风险事件组(n=33)与无风险事件组(n=117);对比不同组间孕妇的临床资料及EWSLP评分;受试者操作特征(ROC)曲线分析EWSLP评分对孕妇发生危重症及产科风险事件的预测价值;对比不同组间孕妇妊娠结局。结果危重组的产次、不良妊娠史比例、血糖、平均动脉压、血清丙氨酸转氨酶(ALT)及EWSLP总分均显著高于非危重组(P<0.05),而分娩孕周、自然分娩比例及胎儿1 min阿普加(1 min Apgar)评分均低于非危重组(P<0.05);风险事件组的不良妊娠史比例、血糖、平均动脉压、血清ALT及EWSLP总分显著高于无风险事件组(P<0.05),而分娩孕周、自然分娩比例及胎儿1 min Apgar评分低于无风险事件组(P<0.05);ROC结果显示,EWSLP预测孕妇发生危重症及产科风险事件的ROC曲线下面积(AUC)分别为0.873、0.861。结论EWSLP对妊娠晚期危重症孕妇及其产科风险事件的发生均具有一定的预测价值,具有良好的临床应用效果,有助于护理人员针对不同孕妇制定相应的护理措施,提高护理效率,降低不良事件的发生。

Objective To investigate the clinical prediction value of early warning score for late trimester of pregnant women(EWSLP)and its guiding significance for nursing work.Methods A prospective study was conducted to collect 150 third trimester pregnant women at 28-32 weeks who were prenatal examined at the General Hospital of the Southern Theatre Command of the Chinese People’s Liberation Army from February 2020 to August 2021,and EWSLP scores were given to all pregnant women.The pregnant women were divided into critical group(n=49)and non-critical group(n=101)according to the progress of their pregnancy,and divided into risk event group(n=33)and non-risk event group(n=117)according to obstetric risk events.The clinical data and EWSLP scores of pregnant women in different groups were compared,and the predictive value of EWSLP score for predicting critical illness and obstetric risk events in pregnant women was analyzed by receiver operator characteristic(ROC)curve.The pregnancy outcomes of the pregnant women in different groups were also compared.Results The parity,proportion of adverse pregnancy history,blood glucose,mean arterial pressure,serum alanine aminotransferase(ALT)and EWSLP total scores in critical group were significantly higher than those in non-critical group(P<0.05)and the gestational age,proportion of spontaneous delivery and fetus 1 minute Apgar(1 min Apgar)score of fetus were lower than those of non-critical group(P<0.05).The proportion of adverse pregnancy history,blood glucose,mean arterial pressure,serum ALT and EWSLP total scores of pregnant women in risk event group were significantly higher than those in non-risk event group(P<0.05),and the delivery gestational age,proportion of natural delivery and 1 minute Apgar score of fetus were lower than those in risk event group(P<0.05).ROC results showed that the area under ROC curve(AUC)of EWSLP for predicting critical illness and obstetric risk events were respectively 0.873 and 0.861.Conclusion EWSLP has certain diagnostic value in predicting the occurrence of critical pregnant women and obstetric risk events in the third trimester of pregnancy and has good clinical application effect,which helps nursing staff to formulate corresponding nursing measures for different pregnant women,improve nursing efficiency,thereby reduce the occurrence of adverse events.