不同创伤评分系统在爆炸伤伤情评估中的比较  

Application of different trauma scoring systems for evaluation of severity of blast injuries

作　　者：康建毅[1] 段朝霞[1] 张洁元[1] 张东冬 KANG Jianyi;DUAN Zhaoxia;ZHANG Jieyuan;ZHANG Dongdong(Sixth Research Department, Daping Hospital (Institute of Field Surgery), Army Medical University (Third Military Medical University), Chongqing, 400042, China)

机构地区：[1]陆军军医大学(第三军医大学)野战外科研究所第六研究室,创伤、烧伤、复合伤国家重点实验室

出　　处：《第三军医大学学报》2019年第15期1403-1406,共4页Journal of Third Military Medical University

基　　金：国家重点研究发展计划(2017YFC0822304)~~

摘　　要：目的探讨适合武器杀伤生物效应评估爆炸伤伤情的创伤评分系统。方法采用某型模拟弹药对开阔地的28只实验兔进行静爆致伤实验,分别使用简明损伤定级标准(abbreviated injury scale,AIS),校正损伤严重度指数(adjusted injury of severity index,ASⅡ)进行伤情判定,研究两种伤情评定方法的优缺点和有效性。结果爆炸距离对ASⅡ评分、AIS评分方法中的损伤严重度评分(injury severity score,ISS)和最大简明损伤定级标准评分(maximal abbreviated injury scale,MAIS)都存在显著影响(P<0.001,P=0.046,P=0.010 6)。ASⅡ、ISS和MAIS评分随着爆炸距离的增加变化率分别为80%、73.6%、54.5%,ASⅡ评分随着距离的增加变化率最大,其次是ISS、MAIS评分。ASⅡ、MAIS和ISS评分与爆炸距离相关系数R分别为0.788 6(P<0.001),0.607 2(P<0.001)和0.566 4(P=0.001 7)。ASⅡ评分与爆炸距离的相关性最好,其次是MAIS、ISS评分。结论ASⅡ评分能有效反映爆炸伤伤情与损伤程度,更适合于武器杀伤生物效应爆炸伤伤情评估。Objective To assess the performance of different trauma scoring systems for evaluating the severity of blast injuries.Methods Twenty-eight rabbits were exposed to blast injuries induced by explosion in an open field.The Abbreviated Injury Scale(AIS)and Adjusted Injury of Severity Index(ASⅡ)scoring system were compared for their performance in the evaluation of the injuries.Results The distance from the explosion significantly affected the ASⅡscore(P<0.001)and both the Injury Severity Score(ISS;P=0.046)and the Maximal Abbreviated Injury Scale score(MAIS;P=0.010 6)in AIS.With the increase in the distance from the explosion,ASⅡscores showed the highest variation rate(80.0%),followed by ISS(73.6%)and then by MAIS score(54.5%).The correlation coefficients of ASⅡ,MAIS and ISS scores with the distance from the explosion were 0.788 6(P<0.001),0.607 2(P<0.001)and 0.566 4(P=0.001 7),respectively,suggesting that ASⅡscores has the best correlation with the distance of explosion,followed by MAIS score and ISS score.Conclusion The ASⅡscoring system allows effective evaluation of the condition and severity of blast injuries and is more suitable for assessing the biological effects of explosions.

关 键 词：爆炸伤 创伤评分系统 武器杀伤生物效应评估 

分 类 号：R64[医药卫生—外科学] R826[医药卫生—临床医学]