产科危重症预警评估工具的研究进展
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摘要
产科危重症是导致孕产妇死亡率增加的重要因素,早期对患者病情进行预警评估,实现及时救治,可有效降低患者的临床病死率,临床意义重大。文章阐述了危重孕产妇的定义、判定标准、产科危重症预警评估工具的研究现状及展望,旨在为护士早期对产科危重症患者进行预警评估提供依据。
Obstetric critical illness plays an important role in increasing maternal mortality.The early warning assessment and taking timely measures can effectively reduce mortality,which is of great clinical significance.The article explains the definition and criteria of maternal near miss,and describe the clinical status of early warning assessment tool,which objective to provide basis for early warning assessment of obstetric critical illness for nurses.
Obstetric critical illness plays an important role in increasing maternal mortality.The early warning assessment and taking timely measures can effectively reduce mortality,which is of great clinical significance.The article explains the definition and criteria of maternal near miss,and describe the clinical status of early warning assessment tool,which objective to provide basis for early warning assessment of obstetric critical illness for nurses.
引文
[1]中华人民共和国国家统计局.中国统计年鉴2015[M].北京:中国统计出版社,2015:92-107.
[2] ANKUM W M.Higher maternal age was associated with increased risks for fetal death and ectopic pregnancy[J].Evidence-Based Medicine,2001,6(1):28.DOI:10.1136/ebm.6.1.28.
[3] VAN K C,PEETERS L L.Clinical aspects of pregnancy after the age of 35 years:a review of the literature.[J]. Human Reproduction Update,1998,4(2):185-194.DOI:10.1093/humupd/4.2.185.
[4] WHO Media Centre.Maternal mortality[EB/OL].(2016-11-20)[2017-09-30]. http://www. who. int/mediacentre/factsheets/fs348/zh/.
[5]姜琦,高莉.产科危重症患者病情评估与预后相关性研究[J].中国妇幼保健,2014,29(11):1673-1674.DOI:10.7620/zgfybj.j.issn.1001-4411.2014.11.13.
[6] PATTINSON R,SAY L,SOUZA J P,et al.WHO maternal death and near-miss classifications[J]. Bulletin of the World Health Organization,2009,87(10):734. DOI:10.2471/BLT.09.071001.
[7] SAY L,SOUZA J P,PATTINSON R C,et al.Maternal near miss-towards a standard tool for monitoring quality of maternal health care[J]. Best Practice&Research Clinical Obstetrics&Gynaecology,2009,23(3):287-296. DOI:10.1016/j.bpobgyn.2009.01.007.
[8] KNAUS W A,DRAPER E A,WAGNER D P,et al. APACHE II:a severity of disease classification system[J].Critical Care Medicine,1985,13(10):818-829. DOI:10.1097/00003465-198603000-00013.
[9] PATERNINA-CAICEDO A J,ROJAS-SUAREZ J A,DUEAS-CASTEL C,et al.Mortality risk prediction with an updated acute physiology and chronic health evaluation II score in critically ill obstetric patients:a cohort study[J].Journal of Intensive Care Medicine,2013,30(2):97-102.DOI:10.1177/0885066613502450.
[10]洪婧贞.改良产科危重症病情评估系统的建立与应用[D].福州:福建医科大学,2011.
[11]邝鉴銮.产科危重症患者病情评估与预后系统的建立与评价[D].广州:广州医学院,2009.
[12]马晓丽,李莲英.产科危重症病情评估系统建立及临床效果评价[J].中国妇幼保健,2016,31(2):227-229.DOI:10.7620/zgfybj.j.issn.1001-4411.2016.02.01.
[13]徐晶.改良产科危重症评分在危重孕产妇病情评估中的意义[J].世界最新医学信息文摘,2017,17(80):196.DOI:10.19613/j.cnki.1671-3141.2017.80.166.
[14] AFESSA B,GREEN B,DELKE I,et al.Systemic inflammatory response syndrome,organ failure,and outcome in critically ill obstetric patients treated in an ICU[J]. Chest,2001,120(4):1271-1277.DOI:10.1378/chest.120.4.1271.
[15] MARTIN S R,FOLEY M R.Intensive care in obstetrics:an evidence-based review[J].American Journal of Obstetrics&Gynecology,2006,195(3):673-689. DOI:10. 1016/j.ajog.2006.05.042.
[16]刘慧姝,王沂峰,徐仲,等.APACHEⅡ评分在综合ICU产科危重患者中的应用[J].中国妇产科临床杂志,2005,6(6):428-431. DOI:10. 13390/j. issn. 1672-1861.2005.06.00.
[17] SUBBE C P,KRUGER M,RUTHERFORD P,et al.Validation of a modified early warning score in medical admissions[J]. Quarterly Journal of Medicine,2001,94(10):521-526.DOI:10.1093/qjmed/94.10.521.
[18] HAMMOND N E,SPOONER A J,BARNETT A G,et al.The effect of implementing a modified early warning scoring(MEWS)system on the adequacy of vital sign documentation[J]. Australian Critical Care,2013,26(1):18-22.DOI:10.1016/j.aucc.2012.05.001.
[19] ESCOBAR G J,LAGUARDIA J C,TURK B J,et al.Early detection of impending physiologic deterioration among patients who are not in intensive care:development of predictive models using data from an automated electronic medical record[J]. Journal of Hospital Medicine,2012,7(5):388-395.DOI:10.1002/jhm.1929.
[20]李萍,姜萍,卫婷婷.改良早期预警评分评估急诊潜在危重症患者病情能力的研究[J].护理管理杂志,2015,15(1):1-2.
[21]韩微,樊雅静,黄翠琴,等.改良早期预警评分在危重孕产妇护理中的应用效果评价[J].上海护理,2016,16(2):9-12.
[22] DE M K,DAS T,HELLEMANS K,et al.Impact of a standardized nurse observation protocol including MEWS after Intensive Care Unit discharge[J]. Resuscitation,2013,84(2):184-188. DOI:10. 1016/j. resuscitation. 2012. 06.017.
[23]董丽丽,王蕊,马国威,等.急危重症病情评估工具在急诊护理中应用研究进展[J].护理管理杂志,2017,17(1):38-40.
[24]王亚丽,张莉,刘宏,等.改良早期预警评分识别病情临床应用现状[J].护理管理杂志,2017,17(5):359-361.
[25] VINCENT J L,MORENO R,TAKALA J,et al.The SOFA(sepsis-related organ failure assessment)score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European Society of Intensive Care Medicine[J]. Intensive Care Medicine,1996,22(7):707-710.
[26]叶宁,骆雪萍.动态监测序贯器官衰竭估计评分在危重病患者预后评估中的应用价值[J].中国全科医学,2012,15(26):3071-3073. DOI:10. 3969/j. issn. 1007-9572 2012.09.068.
[27]刘长文,王剑荣,郑永科,等.高危孕产妇入ICU常见病因与临床干预措施[J].中国急救医学,2013,33(8):727-730.DOI:10.3969/j.issn.1002-1949.2013.8.016.
[28] VINCENT J L,DE M A,CANTRAINE F,et al.Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units:results of a multicenter,prospective study.Working group on"sepsis-related problems"of the European Society of Intensive Care Medicine[J].Critical Care Medicine,1998,26(11):1793-1800. DOI:10.1097/00003246-199811000-00016.
[29] CARLE C,ALEXANDER P,COLUMB M,et al.Design and internal validation of an obstetric early warning score:secondary analysis of the intensive care national audit and research centre case mix programme database[J].Anaesth,2013,68(4):354-367.DOI:10.1111/anae.12180.
[30]陈冬梅,翟玉翠,皮红英.基于英国早期预警评分对急诊护理工作量的研究[J].护理管理杂志,2016,16(5):311-313.
[31] PATERNINA-CAICEDO A,MIRANDA J,BOURJEILY G,et al. Per-formance of the obstetric early warning score in criticallyill patients for the prediction of maternal death[J].American Journal of Obstetrics&Gynecology,2017,216(1):e1-e8.DOI:10.1016/j.ajog.2016.09.103.
[32] CARLSTEIN C,HELLAND E,WILDGAARD K.Obstetric early warning score in Scandinavia. A survey of midwives'use of systematic monitoring in parturients[J]. Midwifery,2018,56(1):17-22. DOI:org/10. 1016/j. midw. 2017. 09.015.
[33]黄雯婧,陆巍.国外孕产妇早期预警评分系统的研究现况及对我国的启示[J].护理管理杂志,2018,18(2):102-106.DOI:10.3969/j.issn.1671-315x.2018.02.007.
[34] OLIVEIRANETO A,PARPINELLI M A,CECATTI J G,et al.Sequential organ failure assessment score for evaluating organ failure and outcome of severe maternal morbidity in obstetric intensive care[J]. The Scientific World Journal,2012,2012(2):1-8.DOI:10.1100/2012/172145.
[35]陈子良,冯劲立.全身炎症反应综合征量化评分对发生多器官功能不全综合征的预警作用[J].深圳中西医结合杂志,2017,27(10):101-102. DOI:10.16458/j. cnki.1007-0893.2017.10.049.
[36]李峥,邹鑫森,李其斌,等.全身炎症反应综合征评分结合血糖及C-反应蛋白变化对预后的预警作用[J].广西医学,2013,35(1):55-57.DOI:10.11675/j.issn.0253-4304.2013.01.18.
[37]杨美丽,熊艳,李娟,等.SIRS评分在产科急危重症病人护理中的应用[J].护理研究,2013,27(9B):2912-2913.DOI:10.3969/j.issn.1009-6493.2013.26.046.
[38] SERAFIM R,GOMES J A,SALLUH J,et al.A comparison of the quick-SOFA and systemic inflammatory response syndrome criteria for the diagnosis of sepsis and prediction of mortality:a systematic review and meta-analysis[J].Chest,2018,153(3):646-655. DOI:10. 1016/j. chest.2017.12.015.
[39]中华人民共和国国家卫生和计划生育委员会.孕产妇妊娠风险评估与管理工作规范[J].中国实用乡村医生杂志,2017,24(12):5-6.DOI:10.3969/j.issn.1672-7185.2017.12.004.
[40]秦敏,杜莉,施红,等.上海市妊娠风险预警评估管理模式初探[J].中国妇幼保健,2011,26(31):4805-4807.
[41]董晓静,常青,李力,等.重庆市危重孕产妇预警管理、救治和转诊系统构建与实施[J].中国实用妇科与产科杂志,2017,33(5):539-543.DOI:10.19538/j.fk2017050124.
[42]李红雨,王丹,罗园,等.重庆市沙坪坝区危重孕产妇风险预警体系运行评估研究[J].中国实用妇科与产科杂志,2017,33(9):945-948.DIO:10.19538/j.fk2017090116.
[2] ANKUM W M.Higher maternal age was associated with increased risks for fetal death and ectopic pregnancy[J].Evidence-Based Medicine,2001,6(1):28.DOI:10.1136/ebm.6.1.28.
[3] VAN K C,PEETERS L L.Clinical aspects of pregnancy after the age of 35 years:a review of the literature.[J]. Human Reproduction Update,1998,4(2):185-194.DOI:10.1093/humupd/4.2.185.
[4] WHO Media Centre.Maternal mortality[EB/OL].(2016-11-20)[2017-09-30]. http://www. who. int/mediacentre/factsheets/fs348/zh/.
[5]姜琦,高莉.产科危重症患者病情评估与预后相关性研究[J].中国妇幼保健,2014,29(11):1673-1674.DOI:10.7620/zgfybj.j.issn.1001-4411.2014.11.13.
[6] PATTINSON R,SAY L,SOUZA J P,et al.WHO maternal death and near-miss classifications[J]. Bulletin of the World Health Organization,2009,87(10):734. DOI:10.2471/BLT.09.071001.
[7] SAY L,SOUZA J P,PATTINSON R C,et al.Maternal near miss-towards a standard tool for monitoring quality of maternal health care[J]. Best Practice&Research Clinical Obstetrics&Gynaecology,2009,23(3):287-296. DOI:10.1016/j.bpobgyn.2009.01.007.
[8] KNAUS W A,DRAPER E A,WAGNER D P,et al. APACHE II:a severity of disease classification system[J].Critical Care Medicine,1985,13(10):818-829. DOI:10.1097/00003465-198603000-00013.
[9] PATERNINA-CAICEDO A J,ROJAS-SUAREZ J A,DUEAS-CASTEL C,et al.Mortality risk prediction with an updated acute physiology and chronic health evaluation II score in critically ill obstetric patients:a cohort study[J].Journal of Intensive Care Medicine,2013,30(2):97-102.DOI:10.1177/0885066613502450.
[10]洪婧贞.改良产科危重症病情评估系统的建立与应用[D].福州:福建医科大学,2011.
[11]邝鉴銮.产科危重症患者病情评估与预后系统的建立与评价[D].广州:广州医学院,2009.
[12]马晓丽,李莲英.产科危重症病情评估系统建立及临床效果评价[J].中国妇幼保健,2016,31(2):227-229.DOI:10.7620/zgfybj.j.issn.1001-4411.2016.02.01.
[13]徐晶.改良产科危重症评分在危重孕产妇病情评估中的意义[J].世界最新医学信息文摘,2017,17(80):196.DOI:10.19613/j.cnki.1671-3141.2017.80.166.
[14] AFESSA B,GREEN B,DELKE I,et al.Systemic inflammatory response syndrome,organ failure,and outcome in critically ill obstetric patients treated in an ICU[J]. Chest,2001,120(4):1271-1277.DOI:10.1378/chest.120.4.1271.
[15] MARTIN S R,FOLEY M R.Intensive care in obstetrics:an evidence-based review[J].American Journal of Obstetrics&Gynecology,2006,195(3):673-689. DOI:10. 1016/j.ajog.2006.05.042.
[16]刘慧姝,王沂峰,徐仲,等.APACHEⅡ评分在综合ICU产科危重患者中的应用[J].中国妇产科临床杂志,2005,6(6):428-431. DOI:10. 13390/j. issn. 1672-1861.2005.06.00.
[17] SUBBE C P,KRUGER M,RUTHERFORD P,et al.Validation of a modified early warning score in medical admissions[J]. Quarterly Journal of Medicine,2001,94(10):521-526.DOI:10.1093/qjmed/94.10.521.
[18] HAMMOND N E,SPOONER A J,BARNETT A G,et al.The effect of implementing a modified early warning scoring(MEWS)system on the adequacy of vital sign documentation[J]. Australian Critical Care,2013,26(1):18-22.DOI:10.1016/j.aucc.2012.05.001.
[19] ESCOBAR G J,LAGUARDIA J C,TURK B J,et al.Early detection of impending physiologic deterioration among patients who are not in intensive care:development of predictive models using data from an automated electronic medical record[J]. Journal of Hospital Medicine,2012,7(5):388-395.DOI:10.1002/jhm.1929.
[20]李萍,姜萍,卫婷婷.改良早期预警评分评估急诊潜在危重症患者病情能力的研究[J].护理管理杂志,2015,15(1):1-2.
[21]韩微,樊雅静,黄翠琴,等.改良早期预警评分在危重孕产妇护理中的应用效果评价[J].上海护理,2016,16(2):9-12.
[22] DE M K,DAS T,HELLEMANS K,et al.Impact of a standardized nurse observation protocol including MEWS after Intensive Care Unit discharge[J]. Resuscitation,2013,84(2):184-188. DOI:10. 1016/j. resuscitation. 2012. 06.017.
[23]董丽丽,王蕊,马国威,等.急危重症病情评估工具在急诊护理中应用研究进展[J].护理管理杂志,2017,17(1):38-40.
[24]王亚丽,张莉,刘宏,等.改良早期预警评分识别病情临床应用现状[J].护理管理杂志,2017,17(5):359-361.
[25] VINCENT J L,MORENO R,TAKALA J,et al.The SOFA(sepsis-related organ failure assessment)score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European Society of Intensive Care Medicine[J]. Intensive Care Medicine,1996,22(7):707-710.
[26]叶宁,骆雪萍.动态监测序贯器官衰竭估计评分在危重病患者预后评估中的应用价值[J].中国全科医学,2012,15(26):3071-3073. DOI:10. 3969/j. issn. 1007-9572 2012.09.068.
[27]刘长文,王剑荣,郑永科,等.高危孕产妇入ICU常见病因与临床干预措施[J].中国急救医学,2013,33(8):727-730.DOI:10.3969/j.issn.1002-1949.2013.8.016.
[28] VINCENT J L,DE M A,CANTRAINE F,et al.Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units:results of a multicenter,prospective study.Working group on"sepsis-related problems"of the European Society of Intensive Care Medicine[J].Critical Care Medicine,1998,26(11):1793-1800. DOI:10.1097/00003246-199811000-00016.
[29] CARLE C,ALEXANDER P,COLUMB M,et al.Design and internal validation of an obstetric early warning score:secondary analysis of the intensive care national audit and research centre case mix programme database[J].Anaesth,2013,68(4):354-367.DOI:10.1111/anae.12180.
[30]陈冬梅,翟玉翠,皮红英.基于英国早期预警评分对急诊护理工作量的研究[J].护理管理杂志,2016,16(5):311-313.
[31] PATERNINA-CAICEDO A,MIRANDA J,BOURJEILY G,et al. Per-formance of the obstetric early warning score in criticallyill patients for the prediction of maternal death[J].American Journal of Obstetrics&Gynecology,2017,216(1):e1-e8.DOI:10.1016/j.ajog.2016.09.103.
[32] CARLSTEIN C,HELLAND E,WILDGAARD K.Obstetric early warning score in Scandinavia. A survey of midwives'use of systematic monitoring in parturients[J]. Midwifery,2018,56(1):17-22. DOI:org/10. 1016/j. midw. 2017. 09.015.
[33]黄雯婧,陆巍.国外孕产妇早期预警评分系统的研究现况及对我国的启示[J].护理管理杂志,2018,18(2):102-106.DOI:10.3969/j.issn.1671-315x.2018.02.007.
[34] OLIVEIRANETO A,PARPINELLI M A,CECATTI J G,et al.Sequential organ failure assessment score for evaluating organ failure and outcome of severe maternal morbidity in obstetric intensive care[J]. The Scientific World Journal,2012,2012(2):1-8.DOI:10.1100/2012/172145.
[35]陈子良,冯劲立.全身炎症反应综合征量化评分对发生多器官功能不全综合征的预警作用[J].深圳中西医结合杂志,2017,27(10):101-102. DOI:10.16458/j. cnki.1007-0893.2017.10.049.
[36]李峥,邹鑫森,李其斌,等.全身炎症反应综合征评分结合血糖及C-反应蛋白变化对预后的预警作用[J].广西医学,2013,35(1):55-57.DOI:10.11675/j.issn.0253-4304.2013.01.18.
[37]杨美丽,熊艳,李娟,等.SIRS评分在产科急危重症病人护理中的应用[J].护理研究,2013,27(9B):2912-2913.DOI:10.3969/j.issn.1009-6493.2013.26.046.
[38] SERAFIM R,GOMES J A,SALLUH J,et al.A comparison of the quick-SOFA and systemic inflammatory response syndrome criteria for the diagnosis of sepsis and prediction of mortality:a systematic review and meta-analysis[J].Chest,2018,153(3):646-655. DOI:10. 1016/j. chest.2017.12.015.
[39]中华人民共和国国家卫生和计划生育委员会.孕产妇妊娠风险评估与管理工作规范[J].中国实用乡村医生杂志,2017,24(12):5-6.DOI:10.3969/j.issn.1672-7185.2017.12.004.
[40]秦敏,杜莉,施红,等.上海市妊娠风险预警评估管理模式初探[J].中国妇幼保健,2011,26(31):4805-4807.
[41]董晓静,常青,李力,等.重庆市危重孕产妇预警管理、救治和转诊系统构建与实施[J].中国实用妇科与产科杂志,2017,33(5):539-543.DOI:10.19538/j.fk2017050124.
[42]李红雨,王丹,罗园,等.重庆市沙坪坝区危重孕产妇风险预警体系运行评估研究[J].中国实用妇科与产科杂志,2017,33(9):945-948.DIO:10.19538/j.fk2017090116.