网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
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
作者:王昆鹏1  杨婕2  王维兴1  张继伟1  于淼1  孙文浩1 
单位: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
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
出版年·卷·期(页码):2019·47·第五期(526-530)
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 thepoor 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 CCⅡwas ≥ 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.

参考文献:

[1] 曾小会.重型颅脑损伤患者的预后影响因素探讨[J].基层医学论坛,2018,22(10):1302-1304.
[2] 张艺滨,王建群,陈良鑫.脑损伤指数在重型颅脑损伤昏迷患者预后评估中的价值[J].中国临床新医学,2017,10(2):117-120.
[3] MASS A I,HUKKELHOVEN C W,MARSHALL L F,et a1.Prediction of outcome in traumatic brain injury with computed tomographic characteristics:a comparison between the computed tomographic classification and combinations of computed tomographic predictors[J].Neurosurgery,2005,57(6):1173-1182.
[4] 陈维庭.正确掌握和使用创伤评分法(AIS-ISS)[J].创伤外科杂志,2001,3(2):81.
[5] BAMES J,HASSAN A,CUERDEN R,et al.Comparison of injury severity between AIS 2005 and AIS 1990 in 8 large injury database[J].Ann Adv Automot Med,2009,53:83-89.
[6] WEISS M,BERNOULLI L,ZOLLINGER A.The NACA scale.Construct and predictive validity of the NACA scale for prehospital severity rating in trauma patients[J].Der Anaesthesist,2001,50(3):150-154.
[7] 周际昌.实用肿瘤内科学[M].2版.北京:人民卫生出版社,2005:45-48.
[8] 饶海承,高卫丰,龚伟,等.不同部位损伤对颅脑外伤患者认知功能的影响[J].东南大学学报(医学版),2014,33(2):137-140.
[9] KIM J J,GEAN A D.Imaging for the diagnosis and management of traumatic brain injury[J].Neurotherapeutics,2011,8(1):39-53.
[10] BAYIR H,CLARK R S,KOCHANEK P M.Promising strategies to mini-mize secondary brain injury after head trama[J].Crit Care Med,2003,31(S1):S112-S117.
[11] 吴兴明,邹永根,石睿,等.伴有颅脑损伤对骨折患者血清中VEGF和TGF-β1水平影响研究[J].中国实验诊断学,2015,19(1):32-34.
[12] 蔺铁,王跃华,罗光东,等.老年中重度颅脑损伤患者CT影像特点及预后的相关性[J].中国老年医学,2014,34(15):4198-4200.
[13] 颜琦.AIS-ISS和GCS评分预测颅脑外伤合并多发伤预后比较研究[D].呼和浩特:内蒙古医科大学,2016.
[14] 赵威,黄杨,王玉同,等.损伤严重程度评分对重度创伤病情评估的意义与预后相关性研究[J].临床误诊误治,2014,27(1):7-10.
[15] 朱勇,孟祥伟,余跃,等.影响颅脑外伤合并多发伤患者预后的危险因素分析[J].海南医学,2015,26(2):239-241.
[16] 刘华,李兵,阮海林,等.GCS、ISS、RTS对颅脑损伤合并多发伤患者预后评估的价值[J].山东医药,2015,55(21):4-6.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 289160 位访问者


 ©《现代医学》编辑部
联系电话:025-83272481;83272479
电子邮件: xdyx@pub.seu.edu.cn

苏ICP备09058541