中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2011年
1期
38-40
,共3页
截肢,创伤性%四肢%创伤和损伤
截肢,創傷性%四肢%創傷和損傷
절지,창상성%사지%창상화손상
Amputation,traumatic%Extremities%Wounds and injuries
目的 比较肢体损伤综合征指数(mangled extremity syndrome index,MESI)、肢体严重损伤严重度评分(mangled extremity severity score,MESS)、截肢指数(limb salvage index,LSI)三种评分方法在判断严重肢体损伤截肢与保肢中的价值.方法 对两所医院近8年来收治的353例严重肢体损伤住院患者进行回顾性分析.患者包括95例截肢,258例保肢.应用三种评分方法评分,通过接收者工作特征曲线(ROC曲线)分析,找到截断点检验其判别能力.结果 三种评分均值在截肢和保肢者之间差异均有统计学意义(P＜0.01).MESI、MESS、LSI三种评分方法的截断点分别为≥20分、≥7分、≥6分,灵敏度为89.47%、85.26%、83.15%,特异度为100%、96.89%、96.12%,符合率为97.16%、93.76%、92.63%,ROC曲线下面积为0.924,0.905,0.861.结论 三种评分方法对严重肢体损伤早期截肢与否均有较好预测能力,但MESI的预测能力最好.
目的 比較肢體損傷綜閤徵指數(mangled extremity syndrome index,MESI)、肢體嚴重損傷嚴重度評分(mangled extremity severity score,MESS)、截肢指數(limb salvage index,LSI)三種評分方法在判斷嚴重肢體損傷截肢與保肢中的價值.方法 對兩所醫院近8年來收治的353例嚴重肢體損傷住院患者進行迴顧性分析.患者包括95例截肢,258例保肢.應用三種評分方法評分,通過接收者工作特徵麯線(ROC麯線)分析,找到截斷點檢驗其判彆能力.結果 三種評分均值在截肢和保肢者之間差異均有統計學意義(P＜0.01).MESI、MESS、LSI三種評分方法的截斷點分彆為≥20分、≥7分、≥6分,靈敏度為89.47%、85.26%、83.15%,特異度為100%、96.89%、96.12%,符閤率為97.16%、93.76%、92.63%,ROC麯線下麵積為0.924,0.905,0.861.結論 三種評分方法對嚴重肢體損傷早期截肢與否均有較好預測能力,但MESI的預測能力最好.
목적 비교지체손상종합정지수(mangled extremity syndrome index,MESI)、지체엄중손상엄중도평분(mangled extremity severity score,MESS)、절지지수(limb salvage index,LSI)삼충평분방법재판단엄중지체손상절지여보지중적개치.방법 대량소의원근8년래수치적353례엄중지체손상주원환자진행회고성분석.환자포괄95례절지,258례보지.응용삼충평분방법평분,통과접수자공작특정곡선(ROC곡선)분석,조도절단점검험기판별능력.결과 삼충평분균치재절지화보지자지간차이균유통계학의의(P＜0.01).MESI、MESS、LSI삼충평분방법적절단점분별위≥20분、≥7분、≥6분,령민도위89.47%、85.26%、83.15%,특이도위100%、96.89%、96.12%,부합솔위97.16%、93.76%、92.63%,ROC곡선하면적위0.924,0.905,0.861.결론 삼충평분방법대엄중지체손상조기절지여부균유교호예측능력,단MESI적예측능력최호.
Objective To compare the values of the mangled extremity syndrome index (MESI), the mangled extremity severity score (MESS) and the limb salvage index (LSI) in deciding amputation or salvage in the management of the mangled extremity syndrome (MES). Methods Clinical data of 353 MES patients including 95 with amputation and 258 with salvage admitted in recent eight years were retrospectively evaluated by using MESI, MESS and LSI, the value of which in deciding amputation or salvage was assessed with receiver operating characteristic ( ROC ). Results There was statistical difference in aspect of mean scores of three grading systems between patients with amputation or salvage (P＜0. 01). For MESI, MESS and LSI, the sensitivities was 89.47%, 85.26% and 83.15% respectively, the specificities was 100%, 96.89% and 96.12% respectively, the coincidence was 97.16%,93.76% and 92.63% respectively, the areas under ROC curves was 0. 924, 0905 and 0. 861 respectively and the cut-off points were equal or over 20, 7 and 6 respectively. Conclusions Three scoring systems are all highly capable of predicting early amputation or not in MES management. The MESI is recommended as a quantitative criterion for determining amputation or salvage.
