新生儿疾病危重评分与美国新生儿紧急生理学评分的比较

Comparision of critical-scoring-system for neonatal acute severity with score for neonatal acute physiology

目的 比较新生儿疾病危重评分法和美国新生儿紧急生理学评分 (SNAP)的优越性 ,探讨更适合我国NICU应用的评分方法。 方法 对我院NICU39例病危新生儿分别用两套评分系统进行评分 ,将结果进行对比分析。 结果 新生儿危重病例评分结果显示 ,非危重组无一例病情转重或死亡 ,危重组病死率为 30 4 7%,极危重组病死率为 10 0 %。随分值下降 ,具备单项指标的病例增多 ,各组间差异经卡方检验有显著性意义。SNAP结果显示 ,≤ 10分组无一例病情加重或死亡 ,10～ 2 0分组病死率为 2 7 78%,≥ 2 0分组病死率为 85 71%,随分值增加 ,具备单项指标的病例增多 ,各组间差异均有显著性意义。两套评分方法高度相关 ,r=-0 86 16 ,P <0 0 1。 结论 新生儿危重病例评分及SNAP对危重病例的检出率均可达 10 0 %,但前者仅有 10个项目 ,更为简便经济 ,更符合我国国情。单项指标与两套评分方法均平行 ,可作为一个可靠的分辨危重病病例的方法在基层医院推广。

Objective To compare the different advantages between the critical-scoring-system for neonatal acute severity and Score for Neonatal Acute Physiology (SNAP).Methods Thirty-nine critically ill newborns in our NICU were scored by the critical-scoring-system for neonatal acute severity and SNAP separately,then the two outcomes were compared.Results Outcome of the critical-scoring-system for neonatal acute severity showed there was no newborn died or conditions worsening in non-risk group.The mortality was 30\^47% in risk group and 100% in high-risk group.The lower the scores were, the more newborns with single index there were.The difference between the two groups was significant. Outcome of SNAP showed there was no newborn died or conditions worsening in ≤10 group.The mortality was 27\^78% in 10～20 group,and 85\^17% in ≥20 group.With the score increasing,the newborns with single index became more. The difference between the two groups was significant.The two scoring systems were closely interrelated,r=-0\^8616,P<0\^01.Conclusion All the critically ill newborns were picked out by the critical-scoring-system for neonatal acute severity or by SNAP.Because there are only 10 indexes in the former,So it is more simple and convenient,and tally with the actual situation of our country.