AIS-ISS创伤评分、脑损伤指数对颅脑损伤患者预后自理能力的评估价值  

AIS-ISS trauma score and craniocerebral injury index evaluating self-care ability of patients with craniocerebral injury

作　　者：王昆鹏[1] 杨婕[2] 王维兴[1] 张继伟[1] 于淼[1] 孙文浩[1] WANG Kunpeng;YANG Jie;WANG Weixing;ZHANG Jiwei;YU Miao;SUN Wenhao(Neurosurgery Department,the Affiliated Hospital of Chengde Medical College, Chengde 067000, China;Nutrition Department, the Affiliated Hospital of Chengde Medical College, Chengde 067000, China)

机构地区：[1]承德医学院附属医院神经外科,河北承德067000 [2]承德医学院附属医院营养科,河北承德067000

出　　处：《现代医学》2019年第5期526-530,共5页Modern Medical Journal

基　　金：河北省医学科学研究重点课题资助项目(20160013)

摘　　要：目的:探讨AIS-ISS创伤评分与脑损伤指数(craniocerebral injury index,CCII)对颅脑损伤患者出院6个月自理能力的评估价值。方法:回顾性分析132例颅脑损伤患者的临床资料,根据患者出院6个月的远期生活质量评估评分(Karnofsky performance scale,KPS)将患者分为自理能力好组(KPS 51~100分)和自理能力差组(KPS 0~50分),分析患者入院时的AIS-ISS创伤评分和CCII与KPS的相关性,绘制两种评分的受试者工作特征曲线(area under the receiver-operating characteristic curve,ROC),计算曲线下面积,根据敏感度和特异度确定评估标准。结果:入院时的CCII自理能力好组高于自理能力差组,AIS-ISS值自理能力好组低于自理能力差组,差异均有统计学意义(P <0. 05)。CCII与出院6个月KPS呈正相关(r=0. 597,P <0. 01),AIS-ISS创伤评分与出院6个月的KPS呈负相关(r=-0. 627,P <0. 01)。CCII和AIS-ISS创伤评分预测颅脑损伤患者出院6个月KPS的ROC曲线下面积分别为0. 748和0. 802;患者入院时CCII≥2. 5或AIS-ISS创伤评分≤14. 5分时,患者出院6个月的自理能力较好。结论:入院时AIS-ISS创伤评分和CCII对颅脑损伤患者出院6个月KPS均有预测意义,但AIS-ISS创伤评分对患者出院6个月自理能力更具预测价值。Objective: To discuss value of AIS-ISS trauma score and craniocerebral injury index( CCII) on the self-help ability of patients with craniocerebral injury. Methods: 132 cases of postoperative patients with craniocerebral injury were retrospectively analyzed and divided into good self-care ability group( KPS 51-100) and poor self-care ability group( KPS 0-50) according to Karnofsky performance scale( KPS). The correlation between KPS and CCII,as well as AIS-ISS was analyzed;Area under the receiver-operating characteristic curve( ROC) of the two scoring methods was drawn,the area under curve was calculated,and then evaluating criteria was confirmed based on sensitivity and specificity. Results: CCII of good self-care ability group was higher than that of the poor self-care ability group,AIS-ISS was lower than that of the poor self-care ability group,the difference was statistically significant( P < 0. 05). There was a significant positive correlation between CCII and KPS of 6 months after discharge( r = 0. 597,P < 0. 01),the AIS-ISS was negatively correlated with KPS of 6 months after discharge( r =-0. 627,P < 0. 01). The area of the ROC curve of that CCII and AIS-ISS predicting KPS of 6 months after discharge on patients with craniocerebral injury were respectively 0. 748 and 0. 802;the results showed when CCII was≥2. 5 and AIS-ISS was≤14. 5 on admission,KPS of 6 months after discharge was better. Conclusion: AIS-ISS trauma score and CCII are both predictive for KPS of 6 months after discharge on patients with craniocerebral injury,but AIS-ISS is more closely related to self-care ability and more predictive.

关 键 词：颅脑损伤 脑损伤指数 AIS-ISS创伤评分 自理能力 远期生活质量评估评分 

分 类 号：R651.15[医药卫生—外科学]