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    两种新生儿早期预警评分表对新生儿重症监护病房转入率的预测作用比较

    Comparison of predictive effect of two neonatal early warning scores on transfer rate of newborns to neonatal intensive care unit

      摘要
    • 摘要:
      目的探讨改良新生儿早期预警评分表(MNEWS)和新生儿早期预警评分表(NEWS)对新生儿重症监护病房(NICU)转入率的预测作用。
      方法采用MNEWS和NEWS对328例新生儿进行评估，根据评估分数分析两种预警评分量表对新生儿转入NICU的预测作用。根据患儿是否入住NICU分为入住NICU组和普通病房组，比较2组新生儿的MNEWS和NEWS评分所用时间。
      结果入住NICU组新生儿MNEWS总分≥6分、单项≥3分例数及新生儿总分均明显高于普通病房组(P < 0.01)，且单项分指标的预测率(87.50%)明显高于总分预测率(70.24%)(P < 0.01)。入住NICU组新生儿NEWS总分≥2分例数及新生儿总分均明显高于普通病房(P < 0.01)。MNEWS对新生儿转入NICU的预测的ROC曲线下面积(AUC)、95% IC、敏感度、特异度分别为0.899、0.889~0.934、89.28%、81.13%，NEWS对新生儿转入NICU的预测的AUC、95%IC、敏感度、特异度分别为0.712、0.687~0.765、69.12%、76.65%。MNEWS评估患儿入院时得分所用评估时间为(54.12±3.51) s，明显长于NEWS的(49.15±3.25) s (t=18.81，P < 0.01)。
      结论MNEWS和NEWS对新生儿转入NICU均有预测作用，MNEWS指标区间更加细致合理，对新生儿转入NICU有更高的预测作用，值得在临床推广应用。

       

      Abstract:
      ObjectiveTo investigate the predictive effects of modified newborn early warning score(MNEWS) and newborn early warning score(NEWS) on the transfer of newborns to neonatal intensive care unit(NICU).
      MethodsMNEWS and NEWS were used to evaluate 328 newborns.According to the evaluation scores, the predictive effects of the two early warning scores on the transfer rate of newborns to NICU were analyzed.According to whether the children were admitted to NICU, they were divided into NICU group and general ward group.The scoring time of MNEWS and NEWS in the two groups were compared.
      ResultsThe total MNEWS score≥6 points, number of cases with single score ≥3 points and total score of newborns in NICU group were significantly higher than those in general ward group(P < 0.01), and the prediction rate of single score(87.50%) was significantly higher than that of total score(70.24%)(P < 0.01).The total NEWS score ≥2 points and total score of newborns in NICU group were significantly higher than those in general ward group(P < 0.01).The area under ROC curve(AUC), 95%IC, sensitivity and specificity of MNEWS for transfer of newborns to NICU were 0.899, 0.889-0.934, 89.28% and 81.13%, respectively.The AUC, 95% IC, sensitivity and specificity of NEWS for transfer of newborns to NICU were 0.712, 0.687-0.765, 69.12% and 76.65%, respectively.The scoring time of MNEWS to evaluate the scores of children on admission was(54.12±3.51) s, which was significantly longer than(49.15±3.25) s of NEWS(t=18.81, P < 0.01).
      ConclusionsBoth MNEWS and NEWS can predict the transfer of newborns to NICU.The index range of MNEWS is more detailed and reasonable, and MNEWS has a higher predictive effect on the transfer of newborns to NICU, which is worthy of clinical application.

       

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