洛杉矶院前卒中筛查量表在院前卒中的应用研究  

Study on application of pre-hospital stroke by los angeles pre-hospital stroke screen

作　　者：陈月馨 周惠芬[1] 彭海菁 张志[1] 方向红 杨美兰 张贵昌[1] 

机构地区：[1]深圳市第四人民医院重症医学科,广东518033

出　　处：《脑与神经疾病杂志》2012年第4期258-260,共3页Journal of Brain and Nervous Diseases

基　　金：深圳市科技计划项目(201003226);福田区公益性科研项目(FTWS201019)

摘　　要：目的探讨洛杉矶院前卒中筛查量表(LAPSS)在院前卒中诊断中的早期诊断价值。方法入组病例选择院前接诊的以神经系统局灶症状或体征为主要表现的92例患者,通过LAPSS进行卒中筛查。结合最终临床诊断,评价LAPSS对院前卒中诊断价值。结果①92例患者临床诊断为卒中49例,其中24例为出血性卒中,25例缺血性卒中。漏诊4例,误诊4例,漏诊或误诊原因均与神经系统查体有关;②LAPSS筛查的统计学分析:灵敏度91.8%,特异度90.7%,漏诊率8.2%;误诊率9.3%,Youden指数0.83,阳性似然比9.87,阴性似然比0.09。完成LAPSS筛查平均时间为4分42秒。结论 LAPSS在院前卒中诊断中具有较高的特异性和敏感性,急诊时可快速、准确判断卒中,值得院前急诊推广。Objective To study the value of the Los Angeles Pre-hospital Stroke Screen （LAPSS） in early diagnosis of pre-hospital stroke. Methods Totally, there were 92 patients in pre-hospital service with neurological symptoms and signs were screened for stroke by LAPSS. The LAPSS was applied to screen stroke. The screen results were compared with the final clinical diagnosis to evalueate the value of LAPSS in diagnosis of pre-hospital stroke. Results Among the 92 patients, there were 49 patients screened by LAPSS to be stroke were eventually confirmed by the final clinical diagnosis. Four patients were misdiagnosed and four patients were missed diagnossis because of wrong nervous system examination. The sensitivity, specificity ,and Youden index of LAPSS were 91.8% ,90.7% and 0.83, respectively. The positive and negative likelihood ratio were 9.87 and 0.09, respectively. The average time to complete LAPSS was 4 minutes and 42 seconds. Conclusion The LAPSS has higher specificity and sensitivity in preospital diagnosis of stroke, which makes more rapidly and correct stroke measurement in emergency treatment, and can be used in pre-hospital diagnosis of stroke widely.

关 键 词：脑卒中 洛杉矶院前卒中筛查量表 院前急救 

分 类 号：R741.02[医药卫生—神经病学与精神病学]