论文部分内容阅读
目的 评估新生儿疾病危重度评分系统的准确性。方法 应用该评分系统对 1992～ 1996年间在NICU住院的 767例新生儿进行评分。所有病例均在入院 2 4h内根据 10项测量、总分 10 0分的评分方法做第一次评分后 :①病情无加重者隔天评分 ;②病情加重时即予评分 ,至病情稳定后按①执行 ;③病情加重并继续恶化者 ,每天评分至死亡为止。全部病例按不同分值 ,划分为非危重组 (>90分 )、危重组 (70～ 90分 )及极危重组 (<70分 )。另对符合“危重病例单项指标”者亦将指标与分值进行比较。结果 非危重组无一例死亡 ,危重、极危重组中 ,分值越低其病死率越高 ,各组间病死率均有显著差异。 10项测量中 ,虽只做 9项测量 ,亦能将 81 5 8%的危重病例和 87 94%的死亡病例检出 ,若只做 8项测量 ,则只能将 40 71%的危重病例及 5 7 79%的死亡病例检出。10项测量项目中心率、血压、pH、红细胞压积比 (φRBC)、胃肠道损害在 4、6、10分值间病死率均有显著差异。符合“危重病例单项指标”的 2 69例中 ,91 45 %评分均属危重。结论 评分系统能把所有危重病例包括在内 ,非危重组无一例死亡 ,说明评分系统准确 ;如条件所限 ,10个测量项目中只做 9项 ,亦可把绝大多数危重病例检出 ;危重病例单项指标亦能反映疾病危重度。建议条件
Purpose To assess the accuracy of the Neonatal Disease Criticality Scoring System. Methods The scoring system was used to score 767 newborns hospitalized in the NICU from 1992 to 1996. All cases were admitted to hospital within 24 hours according to 10 measurements, the total score of 10 0 score method after the first score: ① no exacerbation of the next day score; ② exacerbation of the score, to the stable condition after the press ① executive; ③ exacerbations and continued deterioration, daily score until death. All cases were divided into non-critically ill group (> 90 points), critically ill group (70-90 points) and critically endangered group (<70 points) according to different scores. Another complies with “critically ill patients single indicators” who also indicators and scores were compared. Results In non-critically ill group, none of the patients died. In the critically ill and critically ill patients, the lower the score was, the higher the case fatality rate was. The case fatality rates among the two groups were significantly different. Of the 10 measurements, only 9 measurements were done and 81 58% of critical cases and 87 94% of deaths were detected. If only 8 measurements were taken, only 40 71% of the critical cases and 5 7 79% of the deaths were detected. 10 items measured center rate, blood pressure, pH, hematocrit ratio (φRBC), gastrointestinal damage in 4,6,10 scores were significantly different mortality. Of the 299 cases that met the “Criteria for Individuals with Critical Illness”, 91 45% of the scores were in critical condition. Conclusion The scoring system can cover all the critical cases, and none of the critically ill patients died. It shows that the scoring system is accurate. If the conditions are limited, only 9 of the 10 measurement items can be detected, and most critically ill cases can be detected. Critically ill case individual indicators can also reflect the severity of the disease. Recommended conditions