GCS-Pupils评分在急性脑出血患者预后评估中的应用效果  

Application Effect of GCS Scoring on the Prognosis Evaluation of Patient with Acute Cerebral Hemorrhage

作　　者：宁书蔚 柳颖 赵春刚 NING Shuwei;LIU Ying;ZHAO Chungang(Department of Critical Care Medicine,Geriatrics Center,Dalian Friendship Hospital Affiliated to Dalian Medical University,Dalian 116001,China)

机构地区：[1]大连医科大学附属大连市友谊医院老年医学中心重症医学科,辽宁大连116001

出　　处：《中国医药指南》2022年第26期85-88,共4页Guide of China Medicine

摘　　要：目的探讨GCS-Pupils评分(GCS-P评分)在急性脑出血患者预后评估中的应用效果。方法选取2019年1月至2021年8月收入大连市友谊医院重症医学科病房的急性脑出血患者69例作为研究对象,进行前瞻性目标监测,收集患者入院时的一般特征资料(包括性别、年龄、入院时瞳孔变化情况),将69例患者按格拉斯哥结局量表(GOS)评分分为预后良好组(包括恢复良好和中残)、预后差组(包括重残和植物状态生存)及死亡组,对比3组GCS评分、GCS-P评分及瞳孔变化的差异。应用ROC曲线对比分析GCS-P评分与GCS评分对急性脑出血患者预后的评价效果。结果GCS评分、GCS-P评分、入院时患者瞳孔变化分别与患者存活率存在相关性,GCS评分、GCS-P评分越高,患者的存活率越高,入院时患者双瞳孔均有反射其存活率最高(P<0.05);预后良好组GCS评分及GCS-P评分最高,死亡组GCS评分及GCS-P评分最差,预后差组居中,且3组患者瞳孔变化均差异有统计学意义(P<0.05)。通过应用ROC曲线对比GCS评分、GCS-P评分发现,GCS-P评分在预测急性脑出血患者预后的准确性高于GCS评分。结论GCS-P评分对于临床判断急性脑出血患者预后更为准确可靠。Objective To investigate the effect of GCS-Pupils score(GCS-P score)on the prognosis of patients with acute cerebral hemorrhage.Methods A total of 69 patients with acute cerebral hemorrhage admitted to the intensive care unit of Dalian Friendship Hospital from January 2019 to August 2021 were selected as the research subjects.Prospective testing of patients,general characteristics of the patients at admission were collected(including gender,age,and pupil changes),69 patients were grouped according to Glasgow outcome scale(GOS)score,divided into group of good prognosis(good recovery and moderate disability),group of poor prognosis(severe disability and vegetative state),group of death.The differences of GCS score,GCS-P score and pupil changes were compared among the three groups.ROC curve was used to compare and analyze the effect of GCS-P score and GCS score on the prognosis of patients with acute cerebral hemorrhage.Results The GCS score,GCS-P score and pupil change on admission were all correlated with survival rate,the higher the GCS score and GCS-P score,the higher the survival rate of patients,patients with both pupil reflexes on admission had the highest survival rate,with statistically significant(P<0.05).The GCS score and GCS-P score were the highest in the group with good prognosis,GCS score and GCS-P score were the worst in the death group,the group of poor prognosis was in the middle,there were differences in pupil changes among the three groups(P<0.05).By applying ROC curve to compare GCS score and GCS-P score,it was found that GCS-P score was more accurate than GCS score in predicting the prognosis of patients with acute cerebral hemorrhage.Conclusion Gcs-p score is more accurate and reliable for clinical prognosis of patients with acute cerebral hemorrhage.

关 键 词：急性脑出血 瞳孔变化 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]