CAJ | 학술논문

目的：对比不同评分系统对严重外伤患者预后的评估价值。方法对海南医学院附属医院于2012年9月至2013年9月收治的400例严重外伤患者分别进行急性生理和慢性健康状况评分Ⅱ(APACHEⅡ评分)、改良早期预警评分(MEWS)及简单临床评分(SCS)，对比三种评分系统对患者预后的评估效果。结果随着病死率的上升，三种评分亦随之逐渐升高。APACHEⅡ评分的误差值最小(0.026)，MEWS评分的误差值最大(0.034)；APACHE评Ⅱ分的ROC曲线下面积最大(0.866)，MEWS评分的曲线下面积最小(0.749)。结论 MEWS评分、APACHEⅡ评分及SCS评分均可以有效地对严重外伤患者的预后进行评估，但APACHEⅡ评分的评估准确度最高，MEWS评分准确度最低。而SCS评分系统操作方便、快速、准确度较好，更有利于早期对严重外伤患者预后的评估。
목적：대비불동평분계통대엄중외상환자예후적평고개치。방법대해남의학원부속의원우2012년9월지2013년9월수치적400례엄중외상환자분별진행급성생리화만성건강상황평분Ⅱ(APACHEⅡ평분)、개량조기예경평분(MEWS)급간단림상평분(SCS)，대비삼충평분계통대환자예후적평고효과。결과수착병사솔적상승，삼충평분역수지축점승고。APACHEⅡ평분적오차치최소(0.026)，MEWS평분적오차치최대(0.034)；APACHE평Ⅱ분적ROC곡선하면적최대(0.866)，MEWS평분적곡선하면적최소(0.749)。결론 MEWS평분、APACHEⅡ평분급SCS평분균가이유효지대엄중외상환자적예후진행평고，단APACHEⅡ평분적평고준학도최고，MEWS평분준학도최저。이SCS평분계통조작방편、쾌속、준학도교호，경유리우조기대엄중외상환자예후적평고。
Objective To compare the appraisal values in different scoring for the prognosis of patients with severe trauma. Methods A total of 400 cases of patients with severe trauma from September 2012 to September 2013 in the Affiliated Hospital of Hainan Medical University were graded by acute physiology and chronic health eval-uation (APACHEⅡ), modified early warning score (MEWS) and simple clinical scoring (SCS). And then the effects of evaluation in three kinds of scoring systems for the prognosis of patients were compared. Results With the case fa-tality rate increasing, the scores of three kinds of scoring system were also increased as well. APACHEⅡshowed the minimal error value (0.026), while MEWS showed the maximal error value (0.034). The area under ROC curve of APACHEⅡ was maximal (0.866), while the area under ROC curve of MEWS was least (0.749). Conclusion All these three score systems can effectively predict the outcomes of patients with severe trauma, and the assessing accura-cy is highest in APACHEⅡand lowest in MEWS. SCS scoring system is accurate and easy and fast to be used, which is more conducive to early prognosis for patients with severe trauma.