全面无反应性量表和格拉斯哥昏迷评分量表对神经重症监护病房患者意识障碍和短期预后的评估价值比较  

Comparison of FOUR scale and GCS in Evaluating the Consciousness Disorder and the Short-term Prognosis in NICU Patients

作　　者：季云[1] 卢丽华[1] 姜新娣[1] JI Yun;LU Lihua;JIANG Xindi(Neurological Intensive Care Unit,Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu Province,China)

机构地区：[1]南通大学附属医院神经内科重症监护病房

出　　处：《解放军护理杂志》2019年第9期18-21,共4页Nursing Journal of Chinese People's Liberation Army

基　　金：南通大学附属医院院级科技项目（Tfh1515）

摘　　要：目的通过对意识障碍患者同时采用全面无反应性量表(full outline of unresponsiveness,FOUR)和格拉斯哥昏迷评分量表(Glasgow coma scale,GCS)评分,比较两个量表对患者意识障碍程度准确性及预后的评估价值。方法便利抽样选择2016年1月至2017年6月入住我院神经重症监护病房(neurological intensive care unit,NICU)的99例意识障碍患者作为研究对象。在患者入住NICU72h内进行FOUR和GCS评分,比较使用GCS和FOUR量表评分所需时间以及其对患者意识障碍程度及预后评估的差别。结果两表评分所需时间差异无统计学意义(P>0.05),且与意识障碍水平均呈正相关(P<0.001);FOUR和GCS预测昏迷的ROC曲线下面积(AUC)分别为0.897、0.913(P=0.5759);两表得分与改良Rankin量表评分均呈负相关(P<0.001);FOUR、GCS量表预测住院期间死亡的AUC分别为0.766、0.729,预测住院期间是否残疾及死亡的AUC分别为0.703、0.723,两者比较差异均无统计学意义(均P>0.05)。结论FOUR与GCS量表评分所需时间相当,两量表均可用于判断NICU患者意识障碍的程度及预后。Objective To compare the two scales,Full Outline of Unresponsiveness (FOUR) and Glasgow Coma Scale (GCS),in evaluating the consciousness disorder and the prognosis in patients with disturbance of consciousness.Methods By convenience sampling method,totally 99 patients with consciousness disturbance admitted in the neurological intensive care unit (NICU) were selected as the subjects from January 2016 to June 2017.FOUR scale and GCS scale were performed within 72 hours of admission to NICU.The time needed to assess the scores of GCS and FOUR and their differences in the degree of consciousness disturbance and prognosis were compared.Results The mean time spent in the assessment with FOUR and GCS was almost the same( P >0.05).The FOUR scores and GCS scores were positively correlated with the level of consciousness disturbance ( P <0.001).The area under the ROC curve (AUC) predicted by FOUR and GCS in predicting coma was 0.897 and 0.913,respectively ( P =0.5759).The scores of the two scales were negatively correlated with those of the modified Rankin scale ( P <0.001).The AUC of FOUR and GCS scales in predicting hospital death were 0.766 and 0.729, respectively;the AUC of predicting disability and death during hospitalization was 0.703 and 0.723, respectively;and there was no significant difference between them (all P >0.05).Conclusions FOUR and GCS scales take the same time to score.Both scales can be used to judge the degree and prognosis of consciousness disorder in NICU patients.

关 键 词：意识障碍 FOUR量表 GCS量表 预后 

分 类 号：R473[医药卫生—护理学]