林毅++张国锋++张国和++陈骏

【摘要】目的探讨改良早期预警评分（MEWS）与改良创伤评分（RTS）对成人创伤急诊分流与预后的评估价值。

方法选取2016年1～12月期间在急诊科就诊的63例成人创伤患者作为研究对象，入急诊科即刻分别进行MEWS、RTS评分，追踪患者分流及预后情况。根据分流情况将患者分为急诊ICU组和非急诊ICU组，根据预后将患者分为存活组和死亡组，统计分析MEWS、RTS对成人创伤急诊分流和预后的评估能力。

结果就诊时，急诊ICU组患者MEWS评分高于非急诊ICU组患者，RTS评分低于非急诊ICU组患者，差异有统计学意义（P<0.001）。存活组患者MEWS评分低于死亡组患者，RTS评分高于死亡组患者（P<0.001）。关于MEWS评分与RTS评分准确率的比较，MEWS能准确区分非急诊ICU成年创伤患者是否入住ICU，差异有统计学意义（P<0.05）。MEWS评分对成人创伤急诊预后的评估准确率低于RTS评分，RTS能准确区分急诊成人创伤患者是否存活，差异有统计学意义（P<0.05）。

结论MEWS、RTS评分在成人创伤急诊分流及预后中各有优势，应该根据实际情况综合应用，加强评估效果。

【关键词】改良早期预警评分；改良创伤评分；急诊；创伤；分流

中图分类号：R64 文献标识码：ADOI：10.3969/j.issn.1003-1383.2017.05.012

Study on evaluation value of MEWS and RTS in emergencytriage and prognosis for trauma in adults

[HJ2][HJ]

LIN Yi，ZHANG Guofeng，ZHANG Guohe，CHEN Jun

（The Second Peoples Hospital Affiliated to Fujian University of Traditional Chinese Medicine，Fuzhou 350000，China）

[HJ2][HJ]

【Abstract】ObjectiveTo evaluate the evaluation value of MEWS（modified early warning score）and RTS（revised traumatic score）in emergency triage and prognosis for trauma in adults.

Methods63 patients who were treated in the emergency department from January，2016 to December，2016 were selected as study subjects.MEWS and RTS scores were performed immediately in the emergency department，triage and prognosis were followed up.Patients were divided into emergency ICU group and non emergency ICU group according to the triage，and divided into survival group and death group according to the prognosis.And then，statistics and analysis were carried out on the evaluation ability of MEWS and RTS in triage and prognosis in adult trauma.

ResultsDuring the visit，the MEWS of emergency ICU group was higher than that of the non emergency ICU group，and the RTS was lower than that of non emergency ICU group，difference was statistically significant（P<0.001）.The MEWS in the survival group was lower than that in the death group，and the RTS was higher in the death group（P<0.001）.The comparison of MEWS and RTS accuracy rate showed that MEWS can accurately distinguish non emergency ICU patients with adult trauma whether to stay in ICU，difference was statistically significant（P<0.05）.The MEWS was less accurate than the RTS in assessing the prognosis of emergency trauma in adults，and RTS can accurately differentiate whether an emergency adult trauma patient was alive or not，difference was statistically significant（P<0.05）.

ConclusionEach of MEWS and RTS scores has its own advantages in emergency triage and prognosis of adult trauma，so they should be applied comprehensively according to the actual situation to strengthen the evaluation effect.endprint

【Key words】MEWS；RTS；emergency；trauma；triage

及时对危重创伤患者进行急救是保证患者生命安全的关键，在急救时，准确、快速地对创伤患者进行评估起着重要的指导作用。创伤严重度的量化逐渐引起了创伤学界的关注，改良早期预警评分（Modified Early Warning Score，MEWS）是基于体温、脉搏、血压、心率、呼吸频率的评分系统，在临床上运用广泛[1]。改良创伤评分（Revised Trauma Score，RTS）包含GCS、呼吸频率、心率三项指标，适用于快速评估急诊创伤患者[2]。本研究应用MEWS评分和RTS评分对63例急诊成人创伤患者进行评分统计分析，以探讨MEWS、RTS评分对成人创伤急诊分流与预后的临床价值。

1资料与方法

1.1临床资料

选取2016年1～12月期间在我院急诊科就诊的63例成人创伤患者作为研究对象，其中男性34例，女性29例，年龄19～83岁，平均（37.42±13.19）岁。……