本文關(guān)鍵詞： 新生兒 早期預(yù)警評(píng)分 危重癥新生兒　出處：《重慶醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過(guò)回顧性分析評(píng)價(jià)新生兒早期預(yù)警評(píng)分表(NewbornEarly Warning Scores，NEWS)識(shí)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(biāo)設(shè)計(jì)一種針對(duì)新生兒的早期預(yù)警評(píng)分表，應(yīng)用該評(píng)分表對(duì)病情惡化需轉(zhuǎn)入NICU的170例住院新生兒（NICU組）進(jìn)行評(píng)估，同時(shí)選用180例病情穩(wěn)定的患兒作為對(duì)照組（非NICU組）。采用受試者工作特性曲線（ROC）確定NEWS識(shí)別危重癥新生兒的最佳界值，計(jì)算其在識(shí)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(yù)測(cè)值和陽(yáng)性預(yù)測(cè)值，并和現(xiàn)有兒童早期預(yù)警評(píng)分表（Pediatric Early Warning Scores，PEWS）的評(píng)分結(jié)果進(jìn)行比較。 結(jié)果：病情惡化需轉(zhuǎn)入NICU的170例病人中，其NEWS評(píng)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(jì)學(xué)意義（z=-15.278,P0.05）。NEWS在識(shí)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(yáng)性預(yù)測(cè)值和陰性預(yù)測(cè)值分別為96.8%、89.3%。對(duì)NICU組中患呼吸相關(guān)疾病和敗血癥患兒NEWS評(píng)分的靈敏度可達(dá)95.3%，特異度達(dá)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(shí)識(shí)別出病情惡化需轉(zhuǎn)入NICU重癥監(jiān)護(hù)和干預(yù)治療的新生兒，也能反映出患兒病情嚴(yán)重程度，與PEWS相比具有較高的敏感性，且其評(píng)價(jià)指標(biāo)簡(jiǎn)便易行，值得臨床進(jìn)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(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R722.1

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