本文關鍵詞： 新生兒 早期預警評分 危重癥新生兒　出處：《重慶醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：通過回顧性分析評價新生兒早期預警評分表(NewbornEarly Warning Scores，NEWS)識別病情惡化需轉(zhuǎn)入NICU患兒的作用。 方法：根據(jù)臨床客觀參數(shù)指標設計一種針對新生兒的早期預警評分表，應用該評分表對病情惡化需轉(zhuǎn)入NICU的170例住院新生兒（NICU組）進行評估，同時選用180例病情穩(wěn)定的患兒作為對照組（非NICU組）。采用受試者工作特性曲線（ROC）確定NEWS識別危重癥新生兒的最佳界值，計算其在識別病情惡化需轉(zhuǎn)入NICU患兒的敏感度、特異度、Youden指數(shù)、陰性預測值和陽性預測值，并和現(xiàn)有兒童早期預警評分表（Pediatric Early Warning Scores，PEWS）的評分結(jié)果進行比較。 結(jié)果：病情惡化需轉(zhuǎn)入NICU的170例病人中，其NEWS評分為[3(2,4)]，病情穩(wěn)定的非NICU組得分為[0(0,1)]，其差異有統(tǒng)計學意義（z=-15.278,P0.05）。NEWS在識別病情惡化需轉(zhuǎn)入NICU病人的ROC曲線下面積為0.958（95%CI），最佳界值是2分，，敏感度、特異度和Youden指數(shù)分別為87.6%、97.2%和84.8%，陽性預測值和陰性預測值分別為96.8%、89.3%。對NICU組中患呼吸相關疾病和敗血癥患兒NEWS評分的靈敏度可達95.3%，特異度達97.2%。且NEWS的敏感度高于現(xiàn)有的PEWS [PEWS1(27.1%)、PEW2(56.5%)]，三者間的特異度差異不明顯（97.2%vs100.0%、100.0%）。 結(jié)論：NEWS能很好的及時識別出病情惡化需轉(zhuǎn)入NICU重癥監(jiān)護和干預治療的新生兒，也能反映出患兒病情嚴重程度，與PEWS相比具有較高的敏感性，且其評價指標簡便易行，值得臨床進一步推廣。
[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.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R722.1

【參考文獻】

相關期刊論文 前10條

1 李春愛;;復方丹參注射液預防早產(chǎn)兒硬腫癥的臨床觀察[J];承德醫(yī)學院學報;2013年02期

2 王文亮;李紅;;復方丹參注射液治療新生兒硬腫癥82例臨床研究[J];湖南中醫(yī)藥大學學報;2011年06期

3 樊紅敏;余建明;;復方丹參注射液聯(lián)合小劑量多巴胺治療新生兒硬腫癥60例效果觀察[J];實用臨床醫(yī)學;2009年09期

4 劉忠興;;復方丹參注射液聯(lián)合低分子右旋糖酐注射液治療新生兒寒冷損傷綜合征療效觀察[J];實用醫(yī)學雜志;2008年06期

5 敬運龍;;復方丹參注射液在兒科的臨床應用和不良反應[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2009年23期

6 李楊方;高瑾;趙玫;寶凌云;吳玉芹;陶娜;劉玲;;新生兒急性生理學評分與危重病例評分在新生兒疾病診治中的應用[J];中國新生兒科雜志;2011年06期

7 許亞萍;伍旭明;;丹參注射液治療心血管疾病的研究進展[J];中國藥業(yè);2012年06期

8 廖玲玲;;復方丹參注射液佐治新生兒硬腫癥療效觀察[J];中國醫(yī)藥指南;2010年16期

9 吳清巖;;小劑量多巴胺、酚妥拉明聯(lián)合復方丹參注射液治療新生兒硬腫癥療效觀察[J];中國社區(qū)醫(yī)師(醫(yī)學專業(yè));2012年21期

10 郭銘玉,郭杰,高麗,姜秀菊,郭學鵬,�？似�,趙德安;新生兒硬腫癥出凝血功能的變化及其臨床意義[J];中國實用兒科雜志;2000年02期

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