摘要
目的研究改良早期预警评分(MEWS)系统在院前急救综合管理中的应用,探讨该方案在院前急救、院前与院内急救无缝隙链接方面的应用价值。方法对照组为2005年1月—2006年12月(4026例)院前急救患者,按照院前急救常规监护方案实施管理;实验组为2007年1月—2008年12月(5203例)院前急救患者,采用MEWS评分系统设计院前急救程序化监护及综合管理方案。对比两组院前急救患者24h留观意外事件发生率和收住院患者30d病死率。结果对照组4026例,24h留观患者742例,意外事件发生率7.82%(58/742);收住院患者30d病死350例,病死率8.69%(350/4026)。实验组5023例,24h留观患者947例,意外事件发生率4.86%(46/947);收住院患者30d病死267例(267/5023),病死率5.32%。实验组与对照组相比,留观患者意外事件发生率间差异有统计学意义(χ2=5.80,P<0.05),收住院患者30d病死率间差异有统计学意义(χ2=39.60,P<0.05)。结论建立在MEWS评分系统上的院前急救程序化监护及综合管理方案,能够降低院前急救患者的意外事件发生率和病死率。
Objective To investigate the application of Modified Early Warning Score （MEWS） system in the integrated management of pre-hospital care.Methods Totally 9229 patients were enrolled in this study,among them 4026 patients received conventional pre-hospital care （control group） from January 2005 to December 2006 and 5203 patients received MEWS-based pre-hospital care from January 2007 to December 2008 （MEWS group）.The outcomes were compared between these two groups.Results In the control group,742 patients underwent 24-hour observation,and the accident rate was 7.82% （58/742）;among 4026 patients who were admitted,the case fatality rate was8.69% （350/4026）..In the MEWS group,947 patients underwent 24-hour observation,and the accident rate was 4.86% （46/947） （χ2=5.80,P〈0.05;compared with control group）;among 5023 patients who were admitted,the case fatality rate was 5.32% （350/4026） （χ2=39.60,P〈0.05;compared with control group）Conclusion The MEWS-based integrated management of pre-hospital care decreases the accident rate and case fatality rate of patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第12期1318-1319,共2页
Chinese General Practice
基金
广西壮族自治区卫生厅科研课题(Z2008394)
