中医危重症评分的临床应用评价

发布时间：2018-09-18 14:05

【摘要】：目的探讨中医危重症评分系统的临床应用价值。方法选取315例重症患者(后剔除3例),采用中医危重症评分进行评估,同时采用英国国家早期预警评分(NEWS)进行评估。以10、20、30d的死亡情况作为评价终点,评估中医危重症评分系统对危重症预测的最佳评分点,同时比较2种评价系统对危重症预测的一致性。结果中医危重症5~7分者,20、30d内死亡率显著增高,与2~4分组比较差异有统计学意义(P0.05);7分者,总死亡率达89.19%(66/74)。NEWS评分5~7分者,20d内死亡率开始有所增高,达11.51%(16/139);7分者,总死亡率达89.04%(65/73)。2种评分系统的曲线拟合度比较Z=0.239,P=0.81,提示中医危重症评分亦具有很好的评价效能。中医危重症评分5分者总死亡率开始增高(P0.05),此时敏感度达97.01%,特异度为76.2%,曲线下面积为0.943,是预测危重症的拐点。结论中医危重症评分对危重症预后有很好的评价作用,5分是区分病情危重和预测预后的分界点。
[Abstract]:Objective to explore the clinical application value of TCM critical disease scoring system. Methods three hundred and fifteen patients with severe illness were selected and evaluated with TCM critical disease score (TCM) and British National early warning score (NEWS). Taking the death rate of 10 ~ 20 days as the evaluation end point, the authors evaluated the optimal score points of the TCM critical disease scoring system for the prediction of critical illness, and compared the consistency of the two evaluation systems for the prediction of the critical disease at the same time. Results the mortality of patients with 5 ~ 7 scores of critical diseases in traditional Chinese medicine increased significantly within 20 days, which was significantly higher than that of 2 groups (P0.05), the mortality rate of those with 7 scores was 89.19% (66 / 74). The mortality rate of those with 5 ~ 7 scores of news scores increased within 20 days, reaching 11.51% (16 / 139) and 7 points, respectively. The total mortality rate was 89.04% (65 / 73), and the curve fitting degree of the two scoring systems was 0.239g / 0.81, which indicated that TCM critical disease score also had a good evaluation efficiency. The total mortality rate of the patients with 5 points of TCM critical disease score began to increase (P0.05), the sensitivity reached 97.01, the specificity was 76.2and the area under the curve was 0.943, which was the inflexion point to predict the critical disease. Conclusion TCM critical disease score has a good effect on the prognosis of critical disease, and 5 is the dividing point to distinguish the severity of the disease from the prognosis.
【作者单位】：广东省第二中医院急诊科;
【分类号】：R278

【相似文献】