Abstract:

Objective　To explore and analyze the impact of different risk level nursing mode based on the score of modified early warning scoring system (MEWS) on patients with severe pneumonia. Methods　A total of 80 patients with severe pneumonia treated at Lianyungang First People's Hospital from May 2020 to May 2023 were selected by the simple random sampling method. They were divided into a control group and a treatment group by computer random numbering, with 40 cases in each group. There were 25 men and 15 women in the control group; they were 28-59 (48.45 ± 6.75) years old; their disease course was 5-13 (8.25±2.02) d; they adopted routine clinical nursing intervention. There were 23 men and 17 women in the treatment group; they were 27-60 (48.18 ± 6.54) years old; their disease course was 6-15 (8.30±2.18) d; they were intervened by the different risk level nursing mode based on the MEWS score. The next day after admission and one day before discharge, the levels of pulmonary function, the effects of symptom improvement, and incidences of complications were analyzed and compared between the two groups by χ² and t tests. Results　After the intervention, the forced expiratory volume in the first second (FEV₁), forced lung volume (FVC), and FEV₁/FVC in the treatment group were significantly higher than those in the control group [(2.12±0.45) L vs. (1.81±0.40) L, (2.55±0.51) L vs. (2.30±0.45) L, and (83.14±6.14)% vs. (78.69±6.65)%], with statistical differences (t=3.26, 2.33, and 3.11; P<0.05). The fever remission time, time for disappearance of rales, cough duration, and running nose duration in the treatment group were shorter than those in the control group [(4.36±1.25) d vs. (5.14±1.45) d, (6.85±1.20) d vs. (8.74±1.15) d, (9.74±1.96) d vs. (12.11±2.38) d, and (7.11±1.30) d vs. (8.45±1.28) d], with statistical differences (t=2.58, 7.19, 4.86, and 4.65; all P<0.05). The total incidence of complications in the treatment group were lower than that in the control group [2.50% (1/40) vs. 20.00% (8/40)], with a statistical difference (χ²=4.51, P<0.05). Conclusion　The application of different risk level nursing mode based on MEWS score in patients with severe pneumonia is effective, and can improve their lung function, reduce the risk of complications, and shorten the duration of clinical symptoms.

Key words:

Modified early warning scoring system, Pneumonia, Pulmonary function, Risk level nursing, Complications

摘要：

目的　探究分析基于改良早期预警评分系统（MEWS）评分的不同风险等级护理模式对重症肺炎患者的影响效果。方法　以简单随机抽样法选取2020年5月至2023年5月在江苏省连云港市第一人民医院接受治疗的80例重症肺炎患者作为研究对象。用计算机随机编号的方式将研究对象分成对照组与治疗组，各40例。对照组男25例、女15例，年龄28～59（48.45±6.75）岁，病程5～13（8.25±2.02）d，采取常规化临床护理干预。治疗组男23例、女17例，年龄27～60（48.18±6.54）岁，病程6～15（8.30±2.18）d，采取基于MEWS评分的不同风险等级护理模式。比较分析两组患者入院次日和出院前1日的肺功能水平、症状改善效果、并发症发生情况。统计学方法采用χ²检验、t检验。结果　干预后，治疗组患者的第1秒用力呼气容积（FEV₁）、用力肺活量（FVC）、FEV₁/FVC均高于对照组［（2.12±0.45）L比（1.81±0.40）L、（2.55±0.51）L比（2.30±0.45）L、（83.14±6.14）%比（78.69±6.65）%］，差异均有统计学意义（t=3.26、2.33、3.11，均P<0.05）。治疗组退热时间、啰音消失时间、咳嗽持续时间、流涕持续时间均短于对照组［（4.36±1.25）d比（5.14±1.45）d、（6.85±1.20）d比（8.74±1.15）d、（9.74±1.96）d比（12.11±2.38）d、（7.11±1.30）d比（8.45±1.28）d］，差异均有统计学意义（t=2.58、7.19、4.86、4.65，均P<0.05）。治疗组并发症总发生率低于对照组［2.50%（1/40）比20.00%（8/40）］，差异有统计学意义（χ²=4.51，P<0.05）。结论　基于MEWS评分的不同风险等级护理模式在重症肺炎患者中的应用效果显著，对改善患者肺功能具有积极影响，可降低并发症发生风险，缩短临床症状持续时间。

关键词:

改良早期预警评分系统, 肺炎, 肺功能, 风险等级护理, 并发症