修改版昏迷恢复量表对意识障碍患者预后的评估价值  

Assessable value of coma recovery scale-revised on prognosis in patients with disorders of consciousness

作　　者：陈炎[1] 谢秋幼[1] 楚淑芳[1] 何艳斌[1] 周锋[1] 倪啸晓[1] 虞容豪[1] 黄瑞旺[2] 

机构地区：[1]广州军区广州总医院神经医学专科医院高压氧与神经康复中心昏迷研究组,510010 [2]华南师范大学心理学院脑成像中心

出　　处：《临床神经病学杂志》2014年第5期370-371,共2页Journal of Clinical Neurology

基　　金：国家自然科学基金(81271548);广东省科技计划[2012(A)030400025]

摘　　要：目的探讨修改版昏迷恢复量表(CRS-R)对意识障碍患者预后的评估价值。方法对29例重症脑部病变意识障碍患者进行CRS-R评分,根据评分分为植物状态(VS)和最小意识状态(MCS)。在患者出院≥3个月后进行格拉斯哥结局量表(GOS)评分;并对两个量表评分的相关性进行分析。结果本组VS患者20例、MCS患者9例,二者CRS-R评分分别为(5.15±2.35)分和(11.88±4.01)分。VS患者GOS评分≤3分(预后差)的比率(95%,19/20)显著高于MCS患者(44.4%,4/9)(P<0.05)。Pearson相关分析显示,CRS-R评分与GOS评分呈正相关(r=0.558,P<0.05)。CRS-R评分的子项中,运动、言语和交流与GOS评分呈正相关(r=0.663,r=0.637,r=0.424,均P<0.05);而听觉、视觉和唤醒度与GOS评分无关。结论意识障碍患者CRS-R评分越高,预后越好。Objective To explore the assessable value of coma recovery scale-revised （CRS-R） on prognosis in patients with disorders of consciousness.Methods Twenty-nine patients with disorders of consciousness caused by severe brain lesions were scored by CRS-R,and they were divided into vegetative state （VS） and minimally conscious state （MCS） according to the scores.Glasgow outcome scale （GOS） were scored in the patients at ≥3 months after discharge.The correlation between the two scales was analyzed.Results There were 20 VS patients and 9 MCS patients in this group,with CRS-R scores were （5.15 ±2.35） and （11.88 ±4.01） respectively.The rate of GOS score ≤3 （poor prognosis） in VS patients （95％,19/20） was significantly higher than that in MCS patients （44.4％,4/9） （P ＜ 0.05）.Pearson correlation analysis showed that CRS-R score was positively correlated with GOS score （r =0.558,P ＜ 0.05）.In the subprojects of CRS-R score,movement,speech and communication were positively correlated with GOS score （r =0.663,r =0.637,r =0.424,all P ＜ 0.05） ; while hearing,vision and arousal were not related to GOS score.Conclusion In patients with disorders of consciousness,the CRS-R score higher,the prognosis better.

关 键 词：修改版昏迷恢复量表 植物状态 最小意识状态 格拉斯哥结局量表 

分 类 号：R749[医药卫生—神经病学与精神病学]