颅脑损伤严重度采用AIS与GCS评定的比较  

Comparison between AlS and GCS in patients with severe head injury

作　　者：朱政鸣[1] 刘科[1] 方波[1] 程凯敏[1] 袁鹏[1] 

机构地区：[1]重庆市急救医疗中心神经外科,400014

出　　处：《重庆医学》2005年第11期1603-1604,1607,共3页Chongqing medicine

基　　金：创伤评分的引进与推广应用研究项目获重庆市卫生局医学科技成果二等奖

摘　　要：目的比较单纯颅脑损伤病人采用简明损伤定级标准(AIS)-90版98更新本评定与格拉斯哥昏迷计分(GCS)分值的关系,对其中不符合的原因予以探讨,并提出改进设想.方法选择单纯颅脑损伤病人356例(其中施行开颅减压及开颅血肿清除术102例),入院时均行GCS检查,伤情分别采用AIS-90版98更新本和GCS评定比较.结果 AIS 5 与颅脑损伤GCS > 8分不符合的24例主要是单纯硬膜外及单纯硬膜下血肿,且中线移位均 < 5mm.若将AIS 5 血肿 > 50ml、中线结构移位≤5mm列入AIS 4,而中线结构移位> 5mm仍列入AIS 5,本组颅脑损伤符合率将由69.6%上升到94.8%.GCS 13～15分的AlS 3～4有147例,两者评定的符合率仅为31.5%.结论 AIS 以解剖为基础;GCS依临床作判断,如何将两者有机结合仍为探索课题.随AIS进一步合理调配各部位所占的评分数值,增加临床内容,可使评分的准确性更高,并随计算机的推广而简化.Objective The relationship between AIS-90（98 new edition） and GCS of simply head-injured patients was compared, The incompatible causes were discussed, and better methods were projected. Methods Three hundred and fifty-six patients who suffered from simple head injury were collected. In these cases, 102 patients were operated. All patients was judged with AIS-90 and GCS on admission. Results AIS 5 and head-injured patients（ GCS〉8 ）in 24 cases who suffered from simple extradural ,subdural hematoma and midline shift〈Smm were incompatible. If AIS 5 with midline shift≤5mm and the volume of hematoma〉50ml was put into AlS 4,the compatible rate of score in patients with severe head injury would increase from 69.6%to 94.8%. The compatible rate in 147 cases of AlS 3-4 and GCS 13-15 only was 31.5 %. Condusion AlS based on anatomy and GCS was judged on clinical data. The two methods should be related each other. If the value of AlS used in one region of human body was regulated reasonably and clinical data was added more,the scale would be gotten exactly. It would be simplified and practical widely in traumatology field as computer was popularized.

关 键 词：创伤分级 昏迷计分 颅脑损伤 

分 类 号：R651.15[医药卫生—外科学]