Glasgow昏迷评分在肝性脑病患者中应用  

Glasgow coma scale in patients with hepatic encephalopathy

作　　者：刘旭[1] 郭晓钟[1] 李宏宇[1] 吴春燕[1] 林浩[1] 刘涵 LIU Xu;GUO Xiao-zhong;LI Hong-yu;WU Chun-yan;LIN Hao;LIU Han(Department of Gastroenterology,The General Hospital of Shenyang Military Command,Shenyang 110016,China)

机构地区：[1]沈阳军区总医院消化内科,辽宁沈阳110016

出　　处：《临床军医杂志》2018年第8期906-907,910,共3页Clinical Journal of Medical Officers

摘　　要：目的评估Glasgow昏迷评分(GCS)对肝性脑病(HE)患者治疗、预后的预测准确度,探讨其临床应用价值。方法回顾性分析沈阳军区总医院消化内科自2016年1月至2017年12月收治的的133例HE患者的临床资料。采用GCS评分系统进行评分、分组。依据GCS分为意识清楚组(n=38)、轻度意识障碍组(n=52)、中度意识障碍组(n=27)和昏迷组(n=16)。分析并比较4组患者在治愈好转率、病死率、重症监护天数、住院天数及住院费用等方面的差异。结果昏迷组治愈好转率37.5%(6/16),显著低于意识清楚组的94.7%(36/38)、轻度意识障碍组的92.3%(48/52)、中度意识障碍组的81.5%(22/27)(P<0.05);昏迷组病死率为62.5%(10/16),显著高于轻度意识障碍组的1.9%(1/52)、中度意识障碍组的18.5%(5/27),意识清楚组无病死者,差异均有统计学意义(P<0.05)。昏迷组、中度意识障碍组患者重症监护天数分别为(5.2±2.1)d、(2.8±1.5)d,显著多于轻度意识障碍组、意识清楚组,差异均有统计学意义(P<0.05)。昏迷组患者住院费用显著高于其他3组(P<0.05)。结论 GCS可较好的预测HE患者的治疗效果,对患者预后评估有指导意义,可进一步在临床工作中应用。Objective To investigate the value of Glasgow coma scale（ GCS） in clinical applications according to evaluate its accuracy in treatment and prognosis of patients with hepatic encephalopathy（ HE）. Methods A retrospective study was performed on 133 cases of HE patients who were admitted from January 2016 to December 2017. GCS scoring system was used for grading and grouping. According to GCS,patients were randomly divided into the clear conscious group（ n = 38）,mild conscious disorder group（ n = 52）,moderate conscious disorder group（ n = 27） and coma group（ n = 16）. The differences of the four groups in the rate of recovery,mortality,days of intensive care,days of hospitalization and hospital expenses were analyzed and compared. Results The cure and improvement rate was 37. 5%（ 6/16） in the coma group,which was significantly lower than that of the clear conscious group（ 94. 7%,36/38）,mild conscious disorder group（ 92. 3%,48/52） and moderate conscious disorder group（ 81. 5%,22/27）（ P〈0. 05）. The mortality rate in the coma group was（ 62. 5%,10/16）,which was significantly higher than that in the mild conscious disorder group（ 1. 9%,1/52） and the moderate conscious disorder group（ 18. 5%,5/27）,there was no death in the clear conscious group（ P〈0. 05）. The ICU duration in the coma group and mild conscious disorder group were（ 5. 2 ± 2. 1） days and（ 2. 8 ± 1. 5） days,respectively,which were more than that in the mild conscious disorder group and the clear conscious group（ P〈0. 05）. The hospital costs in the coma group was significantly higher than that in the other three groups（ P〈0. 05）. Conclusion Glasgow coma scale can better predict the treatment outcome and prognosis of HE patients,which is worth of clinical promotion.

关 键 词：GLASGOW评分 肝性脑病 预后 

分 类 号：R575.3[医药卫生—消化系统]