【摘要】 目的探讨儿童早期预警评分(PEWS)对脓毒症患儿病情及短期预后的预测效果。方法采用回顾性研究方法,选择2018年1—12月广西医科大学第一附属医院儿科重症监护病房(PICU)收治的30例脓毒症患儿,其中严重脓毒症患儿9例,并以同期35例非脓毒症的感染患儿作为对照组,均在入病房时使用PEWS、PCIS进行评分;所有脓毒症患儿根据住院期间死亡事件分为存活组(n=26)和死亡组(n=4),分析PEWS对脓毒症患儿短期预后的预测效果。结果死亡组PEWS得分显著高于存活组(t=1.551,P=0.007);严重脓毒症组PEWS得分均高于脓毒症组、非脓毒症组(F=13.688,P=0.000),脓毒症与非脓毒症组PEWS得分比较,差异无统计学意义(t=0.812,P=0.420);另外,不同组别PEWS与PCIS得分均有显著相关性,两者预测脓毒症患儿死亡的ROC曲线下面积为0.856,0.938,差异无统计学意义(Z=0.706,P=0.480)。结论PEWS可在一定程度上对严重脓毒症患儿的病情和短期预后有预测价值,评分越高提示患儿病情越重,预后越差,但对区分一般脓毒症和感染类危重患儿,仍需要借助其他生化指标进一步确定。更多还原

【Abstract】 Objective To investigate the predictive effects of pediatric early warning score(PEWS) for children with sepsis and short-term prognosis. Methods A total of 30 children with sepsis admitted to the Pediatric Intensive Care Unit(PICU) of the First Affiliated Hospital of Guangxi Medical University from January to December 2018 were selected by retrospective research method, and 9 children with severe sepsis were included. Meanwhile, 35 children with non-sepsis infection in the same period were selected as the control group. PEWS and pediatric critical illness score(PCIS) were used to score when patients entered the ward. All children with sepsis were divided into the survival group(n=26) and the death group(n=4) according to the death events during hospitalization. The predictive effects of PEWS for children with sepsis and short-term prognosis were analyzed. Results The PEWS score in the death group was significantly higher than that in the survival group(t=1.551,P=0.007). PEWS scores of the severe sepsis group were all higher than those of the sepsis group and the non-sepsis group(F=13.688, P=0.000).Meanwhile, there was no significant difference between the sepsis group and the non-sepsis group(t=0.812, P=0.420). In addition, there was a significant correlation between PEWS and PCIS scores in different groups, and the areas under the receiver operating characteristic(ROC) curve for predicting death of children with sepsis were 0.856 and 0.938, without statistically significant difference(Z=0.706, P=0.480). Conclusion PEWS can be applied to predict the illness and short-term prognosis of children with severe sepsis to a certain extent. The higher the score, the worse the illness and the worse the prognosis. However, it is still necessary to apply other biochemical indices to determine the distinguishment of children between general sepsis and critically infectious illness.更多还原