新生儿早期预警评分识别危重症新生儿效能的评价

发布时间：2018-01-22 05:37

本文关键词： 新生儿早期预警评分危重症新生儿　出处：《重庆医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：通过回顾性分析评价新生儿早期预警评分表(NewbornEarly Warning Scores，NEWS)识别病情恶化需转入NICU患儿的作用。方法：根据临床客观参数指标设计一种针对新生儿的早期预警评分表，应用该评分表对病情恶化需转入NICU的170例住院新生儿（NICU组）进行评估，同时选用180例病情稳定的患儿作为对照组（非NICU组）。采用受试者工作特性曲线（ROC）确定NEWS识别危重症新生儿的最佳界值，计算其在识别病情恶化需转入NICU患儿的敏感度、特异度、Youden指数、阴性预测值和阳性预测值，并和现有儿童早期预警评分表（Pediatric Early Warning Scores，PEWS）的评分结果进行比较。结果：病情恶化需转入NICU的170例病人中，其NEWS评分为[3(2,4)]，病情稳定的非NICU组得分为[0(0,1)]，其差异有统计学意义（z=-15.278,P0.05）。NEWS在识别病情恶化需转入NICU病人的ROC曲线下面积为0.958（95%CI），最佳界值是2分，，敏感度、特异度和Youden指数分别为87.6%、97.2%和84.8%，阳性预测值和阴性预测值分别为96.8%、89.3%。对NICU组中患呼吸相关疾病和败血症患儿NEWS评分的灵敏度可达95.3%，特异度达97.2%。且NEWS的敏感度高于现有的PEWS [PEWS1(27.1%)、PEW2(56.5%)]，三者间的特异度差异不明显（97.2%vs100.0%、100.0%）。结论：NEWS能很好的及时识别出病情恶化需转入NICU重症监护和干预治疗的新生儿，也能反映出患儿病情严重程度，与PEWS相比具有较高的敏感性，且其评价指标简便易行，值得临床进一步推广。
[Abstract]:Objective: to evaluate the neonatal early warning Warning Scores by retrospective analysis. Net) to identify the deterioration of the disease needs to be transferred to the role of children with NICU. Methods: according to the clinical objective parameters, we designed an early warning scale for newborns. The score table was used to evaluate 170 hospitalized neonates with NICU who needed to be transferred to NICU for the deterioration of the disease. At the same time, 180 children with stable condition were selected as the control group (non-#en0# group). The optimal threshold value of NEWS for the identification of critically ill neonates was determined by using the operating characteristic curve of the subjects. The sensitivity, specificity, negative predictive value and positive predictive value of NICU were calculated. The results of Pediatric Early Warning score were compared with those of Pediatric Early Warning Scorespews. Results: the NEWS score of 170 patients who needed to be transferred to NICU was as follows: [The scores of stable non-#en0# group were:. [The difference was statistically significant (P < 0.05). The area under the ROC curve needed to be transferred into the ROC curve of NICU patients to identify the deterioration of the disease was 0.95895. The best cutoff value was 2 and the sensitivity was 2. The specificity and Youden index were 87.6% and 84.8% respectively. The positive predictive value and negative predictive value were 96.8% respectively. The sensitivity of NEWS score for children with respiratory related diseases and septicemia in NICU group was 95.3%. The sensitivity of NEWS is higher than that of existing PEWS. [There was no significant difference in specificity among the three groups (97.2vs100.0and 100.050). Conclusion: news can identify the newborns who need to be transferred to NICU intensive care and intervention treatment, and can also reflect the severity of the disease. Compared with PEWS, it has a high sensitivity, and its evaluation index is simple and easy to use, which is worthy of further clinical promotion.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R722.1

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