论文部分内容阅读
目的 评估新生儿危重病例评分法 (草案 )在新生儿重症监护病房 (NICU)中的应用价值。方法 对广州市儿童医院从 1998年 3月至 1999年 12月出车接回在NICU治疗的 177例新生儿按新生儿危重病例评分法进行评分 ,记录并分析有关设备利用、抗生素使用及器官损害等情况。结果 177例新生儿危重病例评分为 <70分组 6例 (3 39% ) ,～ 80分组 2 8例 (15 82 % ) ,～ 90分组 89例 (5 0 2 8% ) ,>90分组 5 4例 (30 5 1% ) ;各组间病死率均有显著性差异 (P <0 0 5 ) ,评分与出生体重之间无明显差异 ,但≤ 15 0 0 g者病死率明显高于 >15 0 0g者(P <0 0 5 )。单项指标符合危重病例者 37例 ,单项指标或评分法评定属于危重病例的组间病死率的差异无显著性 (P >0 0 5 )。机械通气、多种抗生素的应用以及多器官功能损害发生率在评分 >90分组与～ 90分组差异有显著性 (P <0 0 1) ,但～ 80分组与～ 90分组间无明显差异。结论 危重评分能估计病情的程度 ,分值的划分是恰当的。通过评分 ,将分值低于 90分作为转入NICU加强监护、治疗以及基层医院危重新生儿转运的指标。
Objective To evaluate the value of the Newborn Critical Case Score (draft) in neonatal intensive care unit (NICU). Methods A total of 177 newborns who were discharged from NICU in Guangzhou Children’s Hospital from March 1998 to December 1999 were scored according to the Neonatal Critical Case Score Scale. The equipment utilization, antibiotic use and organ damage were recorded and analyzed And so on. Results A total of 177 neonates with critical illness were classified as <70 cases in 6 cases (399%), 80 cases in 28 cases (1582%), 90 cases in 89 cases (588%) and> 90 cases (30 5 1%). The case fatality rate was significantly different between the two groups (P 0 05). There was no significant difference between the score and birth weight, but the case fatality ≤ 15 000 was significantly higher than 15 0 0g (P <0 0 5). There were 37 single criterions in critical cases. There was no significant difference in mortality among the critically ill patients (P> 0.05). The use of mechanical ventilation, multiple antibiotics, and multiple organ dysfunction were significantly different between the scores of 90 and 90 (P <0.01), but there was no significant difference between ~ 80 and ~ 90. Conclusion The critical score can estimate the extent of the disease, the division of scores is appropriate. By grading, a score of less than 90 points is used as an indicator to be transferred to NICU for intensive care, treatment and critically ill neonatal transport in primary hospitals.