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目的探讨新生儿呼吸评分评估新生儿呼吸状况的临床应用价值。方法对我院新生儿科2012年1月至2013年1月收治的呼吸系统疾病新生儿进行呼吸评分,将评分人员分为实习医生、低年资医生、高年资医生3组,分别比较各组评分情况有无差异;根据评分情况将呼吸窘迫程度分为轻、中、重度,对于实习医生和低年资医生评分为中重度呼吸窘迫患儿采取的通气策略及预测呼吸指数(RI)结果与实际采用的通气策略及实际RI结果进行对比。结果共纳入815例呼吸系统疾病患儿,实习医生、低年资医生组分别与高年资医生组对比同一患儿的呼吸评分及分度情况,经Kappa一致性检验,Kappa值分别为0.830、0.913,有高度一致性;根据实习医生及低年资医生评分分度为中重度呼吸窘迫患儿采取的通气策略与实际通气策略比较,经Kappa一致性检验,Kappa值分别为0.781、0.830,分别有较高一致性和高度一致性;预测RI结果与实际RI结果比较,经Kappa一致性检验,Kappa值分别为0.762、0.872,分别有较高一致性和高度一致性。结论新生儿呼吸评分法能准确地评估新生儿的呼吸状况,指导相应治疗,此法简单、易行,适合在基层推广。
Objective To investigate the clinical value of neonatal respiratory rate assessment of neonatal respiratory status. Methods Respiratory score of neonates with respiratory diseases admitted to Department of Neonatology from January 2012 to January 2013 in our hospital were divided into three groups: intern, low-grade doctor and senior-year doctor, and compared the scores of each group Whether there is any difference between the scores; according to the score of respiratory distress will be divided into mild, moderate and severe, for interns and junior doctors score for children with moderate-severe respiratory distress taken by the ventilation strategy and prediction of respiratory index (RI) results and The actual ventilation strategy and actual RI results were compared. Results A total of 815 children with respiratory diseases were enrolled in this study. The scores of respiratory scores and grading of the same child were compared with those of senior medical doctors in the group of interns and junior doctors respectively. The Kappa values were 0.830, 0.913, respectively. According to Kappa consistency test, Kappa values were 0.781,0.830 respectively, according to the scores of interns and junior doctors’ scores in children with moderate-severe respiratory distress. Higher consistency and high consistency. Compared with the actual RI results, the Kappa values of the RI results predicted by the Kappa test were 0.762 and 0.872, respectively, which were highly consistent and highly consistent respectively. Conclusion neonatal respiratory score method can accurately assess the respiratory status of newborns, and guide the appropriate treatment, this method is simple, easy and suitable for promotion at the grassroots level.