中国急救复苏与灾害医学杂志
中國急救複囌與災害醫學雜誌
중국급구복소여재해의학잡지
CHINA JOURNAL OF EMERGENCY RESUSCITATION AND DISASTER MEDICINE
2015年
5期
415-419
,共5页
修正创伤评分%转运前修正创伤评分%地震%躯干伤%休克指数
脩正創傷評分%轉運前脩正創傷評分%地震%軀榦傷%休剋指數
수정창상평분%전운전수정창상평분%지진%구간상%휴극지수
Revised trauma score (RTS)%Earthquake%Torso trauma%Shock index (SI)%revised trauma score prior to being transported (Transport-RTC)
目的：探讨以休克指数作参数的修正创伤评分（RTS）用于地震现场躯干伤伤员转运前伤情评估时的应用价值。方法回顾性分析汶川地震伤情数据库中资料齐全的1322例汶川地震躯干伤伤员数据，其中男553例、女769例，年龄（59.7±21.7）岁。计算伤员的RTS包括创伤分类修正创伤评分（Triage-RTS）和严重创伤转归研究修正创伤评分（MTOS-RTS），并改用休克指数替代收缩压来进行RTS中的循环评估，从而建立转运前修正创伤评分（Transport-RTS）的概念。通过ROC曲线分别比较Transport-RTS与Triage-RTS、MTOS-RTS评价转运中以及急诊室死亡中的作用，分别计算灵敏度、特异度等指标。结果Transport-RTS、Triage-RTS和MTOS-RTS用于地震现场伤员转运前伤情评估时的ROC曲线下面积分别为0.768,0.563,0.563；Transport-RTS的ROC曲线下面积显著大于Triage-RTS和MTOS-RTS，均P<0.05。结论Transport-RTS用于地震现场伤员转运前伤情评估时准确度更高，同时保持了简易、快速的特点。
目的：探討以休剋指數作參數的脩正創傷評分（RTS）用于地震現場軀榦傷傷員轉運前傷情評估時的應用價值。方法迴顧性分析汶川地震傷情數據庫中資料齊全的1322例汶川地震軀榦傷傷員數據，其中男553例、女769例，年齡（59.7±21.7）歲。計算傷員的RTS包括創傷分類脩正創傷評分（Triage-RTS）和嚴重創傷轉歸研究脩正創傷評分（MTOS-RTS），併改用休剋指數替代收縮壓來進行RTS中的循環評估，從而建立轉運前脩正創傷評分（Transport-RTS）的概唸。通過ROC麯線分彆比較Transport-RTS與Triage-RTS、MTOS-RTS評價轉運中以及急診室死亡中的作用，分彆計算靈敏度、特異度等指標。結果Transport-RTS、Triage-RTS和MTOS-RTS用于地震現場傷員轉運前傷情評估時的ROC麯線下麵積分彆為0.768,0.563,0.563；Transport-RTS的ROC麯線下麵積顯著大于Triage-RTS和MTOS-RTS，均P<0.05。結論Transport-RTS用于地震現場傷員轉運前傷情評估時準確度更高，同時保持瞭簡易、快速的特點。
목적：탐토이휴극지수작삼수적수정창상평분（RTS）용우지진현장구간상상원전운전상정평고시적응용개치。방법회고성분석문천지진상정수거고중자료제전적1322례문천지진구간상상원수거，기중남553례、녀769례，년령（59.7±21.7）세。계산상원적RTS포괄창상분류수정창상평분（Triage-RTS）화엄중창상전귀연구수정창상평분（MTOS-RTS），병개용휴극지수체대수축압래진행RTS중적순배평고，종이건립전운전수정창상평분（Transport-RTS）적개념。통과ROC곡선분별비교Transport-RTS여Triage-RTS、MTOS-RTS평개전운중이급급진실사망중적작용，분별계산령민도、특이도등지표。결과Transport-RTS、Triage-RTS화MTOS-RTS용우지진현장상원전운전상정평고시적ROC곡선하면적분별위0.768,0.563,0.563；Transport-RTS적ROC곡선하면적현저대우Triage-RTS화MTOS-RTS，균P<0.05。결론Transport-RTS용우지진현장상원전운전상정평고시준학도경고，동시보지료간역、쾌속적특점。
Objective To study the value of shock index (SI) as reference for assessing those wounded caused by earthquake disaster prior to be transported. Methods A retrospective analysis was conducted on a total of 1,322 wounded (553 males and 769 females) with torso trauma in Wenchuan earthquake, with ages of 59.7 ± 21.7 years old. The values of the revised trauma scores (RTS), including triage-RTS and major trauma outcome study (MOTS)-RTS, were calculated. SI was used instead of SBP in the assessment of circulation in RTC to establish the concept of RTC prior to the transportation (Transport-RTC). The mortality in the transportation to hospital, arrival at the hospital, and during in intensive care unit (ICU) was respectively drawn in a receiver/operator curve (ROC). The areas under the ROC were calculated. Results The area under ROC of Transport-RTS was 0.768, significantly bigger than those of the triage-RTS and MTOS-RTS, 0.563 and 0.563 respectively, both P <0.05.Conclusion Transport-RTS is considered being more specific and effective in assessing the condition of torso trauma caused by earthquake prior to the patients being transported. Simultaneously, it carries out the advantages of simplicity and rapidness.
