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目的探讨改良早期预警评分(MEWS)联合血乳酸水平检测在急危重病患者识别和预后预测中的应用效果。方法该院2015年1月至2017年1月急诊科收治650例患者,入院后进行生命体征(收缩压、心率、呼吸、体温、意识状态)检测,并进行MEWS评估,同时检测乳酸水平,形成MEWSL检测系统。比较患者入院时的MEWS和MEWSL对入住ICU和死亡的预测价值。结果 MEWSL预测患者入住ICU和死亡的灵敏度及准确率均高于MEWS,二者特异度接近。结论对急诊患者采用血清乳酸检测联合MEWS,可以更为准确地识别潜在危重患者,及时给予对症治疗,防止病情进一步恶化。
Objective To explore the application of modified early warning score (MEWS) combined with blood lactate level in the identification and prognosis prediction of acute critical illness patients. Methods A total of 650 patients were admitted to the emergency department from January 2015 to January 2017 in our hospital. After admission, vital signs (systolic pressure, heart rate, respiration, body temperature, and consciousness) were measured and evaluated by MEWS. Lactate levels were also measured MEWSL detection system. The predictive value of MEWS and MEWSL at hospital admission for ICU occupancy and death was compared. Results The sensitivity and accuracy of MEWSL in predicting admission to ICU and death were higher than MEWS, and the specificity of MEWS was close. Conclusions The use of serum lactate test combined with MEWS in emergency patients can identify potential critically ill patients more accurately and give symptomatic treatment in time to prevent the disease from further worsening.