基于改良PEWS评分的分级反应护理在甲型流行性感冒患儿中的应用
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廖柳红，周志坤，冯娜
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1.郑州大学第三附属医院 感染性疾病科，河南郑州，450000；2.河南大学赛思口腔医院 牙体牙髓病科，河南郑州，450000
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摘要：目的 分析基于改良儿童早期预警（PEWS）评分的分级反应护理在甲型流行性感冒（以下简称甲流）患儿护理管理工作中应用效果。方法 回顾性选取 2023 年 3 月至 2025 年 2 月医院感染性疾病科收治的 92 例甲流患儿。科室自 2024 年 1 月 1 日起实施基于改良 PEWS 评分的分级反应护理。将此前收治的 47 例患儿设为对照组（常规护理），此后收治的 45 例患儿设为观察组（分级反应护理），干预持续至出院。比较两组住院时间、住院费用及并发症发生率。计算入院 PEWS 评分，并采用 ROC 曲线评估其对病情严重程度的预测价值。结果 观察组住院时间短于对照组，住院费用更低，并发症发生率更低，差异均有统计学意义(P<0.05)。ROC 曲线显示，改良 PEWS 评分≥1.5 分为预测需护理干预重症患儿的最佳临界值，AUC 为 0.861，灵敏度 85.4%，特异性 76.5%。结论 改良 PEWS 评分可有效评估甲流患儿病情，评分≥1.5 分提示需护理干预风险显著增加。改良 PEWS 有助于早期识别患儿病情变化、实施个性化干预，从而降低并发症发生率，缩短住院时间，减少住院费用，提升医疗安全，具有推广价值。
关健词：分级反应护理；甲型流行性感冒；患儿；儿童早期预警评分；并发症
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Application of Tiered Response Nursing Based on Modified PEWS Score in Children with Influenza A
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Liu Hong Liao,Zhi Kun Zhou,Na Feng
1.Department of Infectious Diseases, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou，Henan 450000, China；2.Department of Endodontics, Seth Stomatological Hospital, Henan University, Zhengzhou 450000, China
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Abstract：Objective To analyze the application effect of tiered response nursing based on the modified Pediatric Early Warning Score (PEWS) in the nursing management of children with influenza A. Methods A total of 92 children with influenza A admitted to the Department of Infectious Diseases between March 2023 and February 2025 were retrospectively selected. Starting from January 1, 2024, the department implemented tiered response nursing based on the modified PEWS. Accordingly, 47 children admitted before this date were assigned to the control group (receiving routine nursing), while 45 children admitted after were assigned to the observation group (receiving tiered response nursing). The intervention continued until discharge. The length of hospital stay, hospitalization costs, and incidence of complications were compared between the two groups. The PEWS scores on admission were calculated, and the predictive value of PEWS for disease severity was evaluated using ROC curve analysis. Results The observation group had a significantly shorter hospital stay, lower hospitalization costs, and a lower incidence of complications compared to the control group (all PConclusion The modified PEWS score is effective in assessing the condition of children with influenza A. A score ≥1.5 indicates a significantly increased risk of requiring nursing intervention. The modified PEWS facilitates early detection of changes in the children's condition and enables personalized interventions, thereby reducing the incidence of complications, shortening hospital stays, decreasing hospitalization costs, improving medical safety, and demonstrating value for promotion.
Keywords : Graded Response Nursing; Influenza A; Children; Pediatric Early Warning Score (PEWS); Complications
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