院前GCS中运动评分与重型颅脑外伤患者预后的关系  

Association between scores of the motor component of the GCS and outcome after severe traumatic brain injury

作　　者：王存祖[1] 谢江宁[2] 常志英[3] 谢正兴[1] 许慧中[1] 丁德群[4] 陈冬云[5] 陈新成[1] 

机构地区：[1]江苏大学附属医院神经外科,江苏镇江212300 [2]江苏大学附属医院急诊科,江苏镇江212300 [3]江苏大学附属医院病案室,江苏镇江212001 [4]江苏大学附属医院医务处,江苏镇江212300 [5]丹阳市中医院神经外科,江苏镇江212300

出　　处：《江苏大学学报（医学版）》2012年第6期503-506,共4页Journal of Jiangsu University：Medicine Edition

基　　金：镇江市卫生科技重点项目(SH2011054);江苏大学临床医学科技发展基金项目(JLY2010142)

摘　　要：目的:分析Glasgow昏迷分级(GCS)中运动评分与重型颅脑外伤(severe traumatic brain injury,sTBI)患者死亡率及愈合结果之间的关系,探讨运动评分应用于院前评估的可靠性。方法:回顾性分析sTBI患者出院病历,统计患者到达急诊室时的GCS评分。预后指标包括ICU死亡率,存活者(生存时间超过1个月)ICU时间、出院时的Glas-gow结果分级(GOS)、伤后第6个月的GOS。结果:本组患者共140例,65例(46.4%)在ICU治疗期间死亡,入院时总GCS评分及睁眼、言语和运动评分与ICU死亡率之间均存在显著性相关,评分越低,死亡率越高,其中最为相关的是总GCS、运动评分。生存时间超过1个月的患者中,运动评分与出院时GOS和伤后第6个月GOS之间均存在显著性相关,评分越高,愈合结果越好。结论:GCS中运动评分与sTBI患者死亡率和愈合结果之间存在显著性相关,可以替代总GCS,作为院前评估指标。Objective：To analyze association between motor scores and outcome after severe traumatic brain injury,and determine motor scores precision and reliability.Methods：A retrospective analysis was performed of severe traumatic brain injury（TBI） patients;the Glasgow coma scale（GCS） of 140 patients arriving to the hospital was recorded.Prognostic indicators included inhospital mortality during intensive care unit（ICU）,days staged in ICU,Glasgow outcome score（GOS） at discharge and six-month after injury in survival patients（1 month）.Results：A total of 140 patients were identified,and 65（46.4%） were died during ICU.The full GCS,the score of motor response,verbal response and eye opening were four independent variables and had significant correlation with mortality.The score of motor response had significant correlation with GOS at discharge and six-month after injury in long time survival patients（1 month）.Conclusion：The motor response score can accurately predict in-hospital death and outcome in severe TBI patients and be used in pre-hospital assessment.

关 键 词：颅脑外伤 Glasgow昏迷分级 院前急救 

分 类 号：R651.1[医药卫生—外科学]