不同创伤评分法对颅脑损伤预后预测价值的比较  

The comparison of the predictive value of different trauma scores on the head injury prognosis

作　　者：沈光建[1] 邹咏文[1] 许民辉[1] 

机构地区：[1]第三军医大学附属大坪医院野战外科研究所神经外科,重庆400042

出　　处：《中华创伤杂志》2001年第3期141-142,共2页Chinese Journal of Trauma

摘　　要：目的　比较格拉斯哥昏迷评分 (GCS)、修正的创伤记分 (RTS)、急性生理和既往健康状况评定Ⅱ (APACHEⅡ )系统在颅脑损伤预后预测中的价值 ,探索适合颅脑损伤预后预测的创伤评分。　方法　回顾性分析 1994～ 2 0 0 0年 116例颅脑损伤患者的临床资料 ,采用Spearman等级相关分析 ,观察入院时GCS、RTS、APACHEⅡ与预后的相关关系。以GOSⅠ～Ⅲ级为危险事件 ,GCS、呼吸频率、收缩压、年龄、既往健康状况等为变量进行Logistic回归分析 ,判定半年预后独立的预计指标。　结果　GCS、RTS、APACHEⅡ均与预后显著相关 (r分别为 0 .6 6 0 ,0 .6 76和 - 0 .5 78) ;Logistic回归分析表明 ,GCS、年龄为独立的预后预计指标。　结论　RTS系统并未表现出比GCS系统更大的优越性。APACHEⅡ适当地与GCS结合应用 ,可提高对颅脑损伤预后预测的准确性。Objective To compare the predictive value of Glasgow co ma scale (GCS), revised trauma score (RTS) and acute phsiology and chronic heal th evaluation (APACHEⅡ) system on head injury prognosis, and selectscorin g systems apt to predicting prognosis of the head injury. Methods The data of 116 case of head injury were reviewed. T he correlation between the score of GCS, RTS, or APACHEⅡ and the patients' prog nosis was determined by Spearman rank relation test on admission. Then, the logi stic regression analysis was administered, in which GOS I～Ⅲ in half year were regarded as risk event. The independent predictive varieties were determined fro m following varieties: GCS, systolic pressure, respiratory rate, age, and chroni c he alth condition. Results GCS, RTS and APACHEⅡ were significantly related wit h the prognosis (r=0.660,0.676 and -0.578, respectively). GCS and age were independent predictive indexes. Conclusions RTS system doesn't show the superiority to GCS sy stem. The predictive accuracy may improve if GCS system is appropriately combine d with APACHEⅡ system.

关 键 词：颅脑损伤 预后 预测 创伤评分法 

分 类 号：R651.15[医药卫生—外科学]