余元霞 陳志明 李俊麗 馬建

[摘要] 目的 探討PCT聯(lián)合NEWS預(yù)警評分在診斷多發(fā)傷后MODS中的應(yīng)用。 方法 選擇2018年5月至2020年5月在我院急診科治療的多發(fā)傷患者60例的臨床資料進(jìn)行回顧性分析，根據(jù)是否發(fā)生MODS分為MODS組（24例）與無MODS組（36例）。比較入住急診科后第1、3、5天PCT水平與NEWS預(yù)警評分，分析PCT水平與MEWS預(yù)警評分對診斷多發(fā)傷后MODS的預(yù)測價值。 結(jié)果 ①入住急診科第1、3、5天，MODS組PCT水平均顯著高于無MODS組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。②入住急診科第1、3、5天，MODS組NEWS預(yù)警評分均顯著高于無MODS組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。③以1.5 μg/L為界值，PCT值預(yù)測MODS的靈敏度為62.5%（15/24），特異度為77.7%（28/36），曲線下面積AUC為0.708。④以6分作為分界值，NEWS預(yù)警評分預(yù)測MODS的靈敏度83.3%（20/24），特異度63.9%（23/36），AUC為0.811。⑤PCT聯(lián)合NEWS預(yù)警評分預(yù)測MODS的靈敏度23/24（95.8%），特異度32/36（88.9%）。 結(jié)論 患者發(fā)生多發(fā)傷后，PCT與NEWS預(yù)警評分可作為預(yù)測MODS的相關(guān)指標(biāo)，兩者聯(lián)合對預(yù)測MODS具有較高的預(yù)測價值。

[關(guān)鍵詞] 降鈣素原;NEWS預(yù)警評分;多發(fā)傷;多器官功能障礙綜合征

[中圖分類號] R641? ? ? ? ? [文獻(xiàn)標(biāo)識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）25-0102-04

Application of procalcitonin combined with National Early Warning Score in the diagnosis of multiple organ dysfunction syndrome after multiple trauma

YU Yuanxia? ?CHEN Zhiming? ?LI Junli? ?MA Jian

Emergency Department，Zhejiang Integrated Traditional Chinese and Western Medicine Hospital （Hangzhou Red Cross Hospital）， Hangzhou? ?310003， China

[Abstract] Objective To investigate the application of procalcitonin （PCT） combined with National Early Warning Score （NEWS） in the diagnosis of multiple organ dysfunction syndrome （MODS） after multiple trauma. Methods The clinical datas of 60 patients with multiple trauma treated in the emergency department of our hospital from May 2018 to May 2020 were analyzed retrospectively.According to the occurrence of MODS，the patients were divided into MODS group （n=24） and non-MODS group （n=36）. PCT levels and NEWS scores on the 1st，3rd and 5th day after admission to the emergency department were compared，and the predictive value of PCT levels and MEWS scores in the diagnosis of MODS after multiple trauma were analyzed. Results On the 1st，3rd and 5th day after admission to the emergency department，the level of PCT in MODS group was significantly higher than that in non-MODS group and the difference was statistically significant （P<0.05）. On the 1st， 3rd and 5th day after admission to the emergency department， the NEWS score of MODS group was significantly higher than that of non-MODS group and the difference was statistically significant （P<0.05）. With 1.5 μg/L as the cutoff value，the sensitivity of PCT value for predicting MODS was 62.5% （15/24），the specificity was 77.7% （28/36）， and the area under the curve AUC was 0.708. ④With 6 points as the cut-off value，the sensitivity of NEWS score to predict MODS was 83.3% （20/24）， the specificity was 63.9% （23/26） and AUC was 0.811.⑤The sensitivity and specificity of PCT combined with NEWS to predict MODS were 23/24 （95.8%） and 30/36 （88.9%）， respectively. Conclusion After the occurrence of multiple trauma， PCT and NEWS can be used as related indexes to predict MODS， and their combination has high predictive value for MODS.