3种现场检伤分类法在芦山地震中的应用价值研究  

Application of three triage methods for those injured in Lushan earthquake

作　　者：白艳[1] 胡海[1] 曹钰[1] 何亚荣[1] 

机构地区：[1]四川大学华西医院急诊科,四川610041

出　　处：《中国急救复苏与灾害医学杂志》2015年第6期541-545,共5页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的比较START检伤分类法、Care—Flight检伤分类法、快速急诊医学评分（rapid emergency medicine score。REMS）检伤分类法对芦山地震伤患者的检伤分类效果。方法回顾性分析2013年4月20日．4月27日从芦山地震现场直接转运至四川大学华西医院急诊科就诊且检伤分类中非绿色的危重地震伤员152例，分别通过START检伤分类法、Care—Flight检伤分类法、REMS检伤分类法将此类患者分类为红色或黄色。分别以是否入住ICU、是否急诊手术为标准对3种检伤分类法制作受试者工作曲线（ROC曲线），计算曲线下面积，并与损伤严重度评分（ISS评分）进行相关性分析。结果以是否入住ICU为标准，分别采用START检伤分类法、Care—Flight检伤分类法、REMS检伤分类法的ROC曲线下面积分别为0．611、0．623、0．767；以是否急诊手术为标准，START检伤分类法、Care—Flight检伤分类法、REMS检伤分类法的ROC曲线下面积分别为O．531、0．512、0．541。Care—Flight检伤分类法、REMS检伤分类法与ISS的Spearman相关系数分别为0．687和0．174（P〈0．0S）。结论START检伤分类法、REMS检伤分类法和Care—Flight检伤分类法均有助于地震危重伤员的检伤分类。其中，REMS法对于地震危重伤员是否需要入住ICU的评估更有效，因此REMS评分高的危重伤员应尽快转运至有ICU设置的医疗机构。Objective To make a comparison on Simple Treatment and Rapid Transpot （START）, Care-Flight Triage and Rapid Emergency Medicne Score （REMS） on the triage process for those injured in Lushan earthquake. Methods A retrospective analysis on the patients of Lushan earthquake that were directly transferred from the earthquake site to Sichuan University Huaxi Hospital emergency department in between April 20 and 27, 2013was completed. Patients assigned to ＂Minor/Green＂ level was not included and remaining 152 patients was assigned to ＂Serious/Yellow＂ and ＂Critical/Red＂ level by START, Care Flight Triage and REMS respectively. Subsequently, the three triage methods whether injuredwas admitted to ICU or to an emergency surgery were performed using area under the receiver-operator curve （AUC）. Results For ICU admission standard, AUC of three groups are： 0.611, 0.623 and 0.767. For emergency operation standard, AUC of the three groups are： 0.531, 0.512 and 0.541. Conclusion The three triage methods are considered being helpful in assessingLushan earthquake injured in their ICU admission and REMS performs better than the rest two methods in the assessment.

关 键 词：START检伤分类 Care—Flight检伤分类法 快速急诊医学评分 地震 

分 类 号：R129[医药卫生—环境卫生学]