创伤评分系统对创伤后多器官功能衰竭的预测性评价  

Predictive assessment of scoring systems for MODS in severe traumatic patients

作　　者：田利华[1] 高伟[1] 唐朝晖[1] 刘开俊[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院创伤外科,湖北武汉430030

出　　处：《创伤外科杂志》2006年第3期202-204,共3页Journal of Traumatic Surgery

摘　　要：目的探讨创伤性多器官功能障碍综合征(MODS)或多器官功能衰竭(MOF)的早期诊断及不同创伤评分系统对其预测价值。方法采用不同的评分方法对124例危重创伤患者的组织损伤程度、伤后生理状态、整体病情变化、器官功能改变及预后预测等方面进行量化评价,将本组MODS发生率、病前状况及继发损害等资料与非MODS患者行量化对比及统计学分析。结果MOF组的损伤严重度评分(ISS)平均为43.56±11.24,损伤部位>2个以上,且AIS最大值≥4的患者占59.42%,器官受损>2个,且单系统感染严重度评分(septic severity score,SSS)≥3分的患者占83.78%,与非MOF组相比差异显著(P<0.05或P<0.01);MOF组患者伤后生理性检测值处于不稳定水平,而非MOF患者分值则逐渐趋于正常。结论动态监测和量化评价原发伤伤情发展、继发病理变化以及引入MODS或MOF危机指数,可提高其预测性。Objective To investigate the early diagnosis of MODS and MOF caused by severe trauma and the predictive value of diffenent scoring system. Methods The data of 124 cases with multiple trauma were assessed by different scoring systems on the bases of injury severity, physiologic state, change in condition, organ function and prognosis etc. MOF and NMOF cases were contrasted and analyzed by severity and statistics in morbidity,preceding status and incorporating harm in posttrauma. Results In MOF group, the mean ISS was 43.56 ± 11.24, there were 59.42% in cases with over 2 injury parts and MAIS≥4,83.78% in dysfunction of cases suffering over 2 organs and single SSS≥3,and there were significant difference between the two groups（ P 〈 0. 05 ＆ P 〈 0. 01）. The level of physiologic status remained instable in MOF group,while these parameters became normal in NMOF group. Conclusion The predicton of crisis in MODS/MOF in patients with severe trauma were dynamically monitored and measured and assessed in development of primary injury and change of the secondary harm and introduced index of crisis for MODS/MOF.

关 键 词：创伤 创伤严重度评分 多器官功能衰竭 多发伤 

分 类 号：R640.7[医药卫生—外科学]