院前指数法联合格拉斯哥昏迷评分在急性酒精中毒合并创伤性颅脑损伤患者评估中的应用  

Evaluation of pre-hospital index combined with Glasgow coma score in patients with acute alcoholism complicated with traumatic brain injury

作　　者：杨伟燕[1] 黄善华[1] 刘路培[1] YANG Weiyan;HUANG Shanhua;LIU Lupei(Emergency Department of Liuzhou People's Hospital,Liuzhou Guangxi 545006,China)

机构地区：[1]柳州市人民医院急诊科,广西柳州545006

出　　处：《中国急救复苏与灾害医学杂志》2023年第6期742-745,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20210202)。

摘　　要：目的探究院前指数法(PHI)联合格拉斯哥昏迷评分(GCS)对急性酒精中毒合并创伤性颅脑损伤(TBI)患者的评估价值。方法随机选取2020年12月—2021年12月入住柳州市人民医院的院前急性酒精中毒合并TBI的患者200例作为研究对象。使用自行设计的PHI评分表及GCS对每位患者的信息进行详细记录。后期采用PHI联合GCS进一步分级,并与创伤严重程度(ISS)评分分级进行比较,以探究其评估结果。结果本研究共纳入200例院前急性酒精中毒合并TBI入院治疗患者,其中188例患者治愈出院,占94.0%;3例患者死亡,占1.5%;9例患者致残,占4.5%。PHI联合GCS评分为(5.53±3.80)分,ISS评分为(13.74±6.27)分。使用PHI联合GCS和ISS评分对院前急性酒精中毒合并TBI患者伤情的敏感性、特异性、准确度、阳性预测值、阴性预测值、Kappa值等评估指标差异均无统计学意义(P>0.05)。ROC曲线分析结果显示,PHI联合GCS和ISS评分法均能够对急性酒精中毒合并TBI患者的伤情进行评估。结论PHI联合GCS评分能够较好地评估急性酒精中毒合并TBI患者的病情,提供及时、精准的诊疗方案,从而提高治愈率。Objective To explore the evaluation value of prehospital index method(PHI)combined with Glasgow Coma Scale(GCS)in patients with acute alcoholism complicated with traumatic brain injury(TBI).Methods A total of 200 patients with pre-hospital acute alcoholism complicated with TBI admitted to Liuzhou People's Hospital from December 2020 to December 2021 were randomly selected as the research objects.Data of each patient enrolled in the study based on a self-designed PHI scale and GCS were recorded.In the later stage,the PHI combined with GCS was further graded and compared with ISS score to explore the results.Results After hospitalization,a total of 188 patients were cured and discharged,accounting for 94.0%.Three patients(1.5%)died.Nine patients(4.5%)were disabled.PHI combined with the GCS score was(5.53±3.80)and the ISS score was(13.74±6.27).There were statistically significant differences in the sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Kappa value between the two methods in assessing the injury of patients with pre-hospital acute alcoholism complicated with TBI(P>0.05).ROC curve analysis showed that PHI combined with GCS score and ISS score had evaluation value in patients with acute alcoholism combined with TBI.Conclusion PHI combined with GCS can better evaluate the condition of patients with acute alcoholism combined with TBI and improve the cure rate.

关 键 词：急性酒精中毒 创伤性颅脑损伤 院前指数法 格拉斯哥昏迷评分 创伤严重程度评分 

分 类 号：R473.74[医药卫生—护理学]