中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2011年
8期
714-716
,共3页
李世波%李树峰%王晋平%田树文%杨大明%孙晋忠%王小铁%杜建英
李世波%李樹峰%王晉平%田樹文%楊大明%孫晉忠%王小鐵%杜建英
리세파%리수봉%왕진평%전수문%양대명%손진충%왕소철%두건영
损伤严重度评分%急救医疗服务%瓦斯爆炸
損傷嚴重度評分%急救醫療服務%瓦斯爆炸
손상엄중도평분%급구의료복무%와사폭작
Injury severity score%Emergency medical services%Gas explosion
目的 探讨和建立适合煤矿瓦斯爆炸伤害的院前评分方法( respiration，pulse，motor and burn,RPMB)。方法 在煤矿创伤院前评分(respiration，pulse and motor，RPM)的基础上，结合煤矿瓦斯爆炸伤的伤情特点，建立RPMB评分方法。选择煤矿瓦斯爆炸伤员251例进行回顾性研究，以入院后ISS≥16分为重伤标准，比较RPMB、RPM、院前指数(prehospital index，PHI)、创伤拣伤标准(trauma triage rule，TTR)对重伤员评价的一致性及漏检率，评价RPMB评分方法在煤矿瓦斯爆炸伤害院前评估中的作用。结果 251例瓦斯爆炸伤害患者经院内AIS - ISS评估为重伤员41例，RPMB与AIS - ISS评分方法一致性高（Kappa值=0.985），RPMB、RPM、PHI、TTR对瓦斯爆炸重伤员评估灵敏度分别为97.6％、26.8％、22.0％和17.1％，特异度分别为88.1％、97.6％、87.6％和95.7％。结论 RPMB评分方法简单、易行，对煤矿瓦斯爆炸伤员检出率高，值得临床推广应用。
目的 探討和建立適閤煤礦瓦斯爆炸傷害的院前評分方法( respiration，pulse，motor and burn,RPMB)。方法 在煤礦創傷院前評分(respiration，pulse and motor，RPM)的基礎上，結閤煤礦瓦斯爆炸傷的傷情特點，建立RPMB評分方法。選擇煤礦瓦斯爆炸傷員251例進行迴顧性研究，以入院後ISS≥16分為重傷標準，比較RPMB、RPM、院前指數(prehospital index，PHI)、創傷揀傷標準(trauma triage rule，TTR)對重傷員評價的一緻性及漏檢率，評價RPMB評分方法在煤礦瓦斯爆炸傷害院前評估中的作用。結果 251例瓦斯爆炸傷害患者經院內AIS - ISS評估為重傷員41例，RPMB與AIS - ISS評分方法一緻性高（Kappa值=0.985），RPMB、RPM、PHI、TTR對瓦斯爆炸重傷員評估靈敏度分彆為97.6％、26.8％、22.0％和17.1％，特異度分彆為88.1％、97.6％、87.6％和95.7％。結論 RPMB評分方法簡單、易行，對煤礦瓦斯爆炸傷員檢齣率高，值得臨床推廣應用。
목적 탐토화건립괄합매광와사폭작상해적원전평분방법( respiration，pulse，motor and burn,RPMB)。방법 재매광창상원전평분(respiration，pulse and motor，RPM)적기출상，결합매광와사폭작상적상정특점，건립RPMB평분방법。선택매광와사폭작상원251례진행회고성연구，이입원후ISS≥16분위중상표준，비교RPMB、RPM、원전지수(prehospital index，PHI)、창상간상표준(trauma triage rule，TTR)대중상원평개적일치성급루검솔，평개RPMB평분방법재매광와사폭작상해원전평고중적작용。결과 251례와사폭작상해환자경원내AIS - ISS평고위중상원41례，RPMB여AIS - ISS평분방법일치성고（Kappa치=0.985），RPMB、RPM、PHI、TTR대와사폭작중상원평고령민도분별위97.6％、26.8％、22.0％화17.1％，특이도분별위88.1％、97.6％、87.6％화95.7％。결론 RPMB평분방법간단、역행，대매광와사폭작상원검출솔고，치득림상추엄응용。
Objective To explore and establish pre-hospital scoring system (respiration, pulse,motor and burn, RPMB) for evaluation of coal mine gas explosion injury. Methods After analysis of characteristics of blast injury caused by coal mine gas explosion, a new pre-hospital scoring system,RPMB, for evaluation of blast injury was established on the basis of pre-hospital evaluation of coal mine injuries (respiration, pulse and motor, RPM). From January 2003 to December 2009, 251 patients with blast injury caused by coal mine gas explosion were collected in this study for a retrospective study. ISS≥16 points was set as the gold standard for severe wound. All the injuries were assessed by RPMB, RMP,pre-hospital index (PHI) and trauma triage rule (TTR). The consistency and detection rate of severe wounds were compared. The sensitivity and specificity were also calculated. Results Of 251 patients,41 patients were evaluated as severe, with high consistency rate between AIS-ISS and RPMB (kappa =0.985). The sensitivity of RPMB, RPM, PHI and TTR was 97.6％, 26.8％ , 22.0％ and 17.1％ respectively and the specificity of those was 88. 1 ％ , 97.6％ , 87.6％ and 95.7％ respectively. Conclusion RPMB is a simple and easy scoring method, with high detection rate of severe wound and potential of clinical applications.
