中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
23期
2830-2832
,共3页
颅脑损伤%全面无反应性量表%格拉斯哥昏迷量表%急性生理与慢性健康状况评分系统Ⅱ%预后
顱腦損傷%全麵無反應性量錶%格拉斯哥昏迷量錶%急性生理與慢性健康狀況評分繫統Ⅱ%預後
로뇌손상%전면무반응성량표%격랍사가혼미량표%급성생리여만성건강상황평분계통Ⅱ%예후
Craniocerebral trauma%Full outline of unresponsiveness scale%Glasgow coma scale%APACHEⅡ%Prognosis
目的:探讨全面无反应性量表(FOUR)预测重型创伤性颅脑损伤(STBI)患者预后的价值。方法选取2012年1月—2013年12月于钦州市第二人民医院治疗的STBI ( GCS评分≤8分)患者95例为研究对象,根据入院28 d内是否发生死亡(包括脑死亡),将患者分为死亡组(37例)和存活组(58例)。收集患者临床资料,包括性别、年龄、颅脑损伤原因及是否手术治疗;由同一研究者在患者入院24 h内对其进行FOUR、 GCS及APACHEⅡ评价。结果死亡组年龄、 APACHEⅡ评分高于存活组, FOUR、 GCS评分低于存活组( P<0.01)。 FOUR预测患者死亡的灵敏度为72%,特异度为85%, ROC曲线下面积(AUC)为0.854〔95%CI (0.762,0.953)〕; GCS预测患者死亡的灵敏度为74%,特异度为87%, AUC为0.873〔95%CI (0.783,0.953)〕; APACHEⅡ预测患者死亡的灵敏度为73%,特异度为83%, AUC为0.861〔95%CI (0.813,0.932)〕。各量表预测患者死亡的AUC比较,差异均无统计学意义(P>0.05)。结论 FOUR预测STBI患者死亡的灵敏度与特异度较高,与GCS、 APACHEⅡ对STBI患者预后的评价具有同等价值。
目的:探討全麵無反應性量錶(FOUR)預測重型創傷性顱腦損傷(STBI)患者預後的價值。方法選取2012年1月—2013年12月于欽州市第二人民醫院治療的STBI ( GCS評分≤8分)患者95例為研究對象,根據入院28 d內是否髮生死亡(包括腦死亡),將患者分為死亡組(37例)和存活組(58例)。收集患者臨床資料,包括性彆、年齡、顱腦損傷原因及是否手術治療;由同一研究者在患者入院24 h內對其進行FOUR、 GCS及APACHEⅡ評價。結果死亡組年齡、 APACHEⅡ評分高于存活組, FOUR、 GCS評分低于存活組( P<0.01)。 FOUR預測患者死亡的靈敏度為72%,特異度為85%, ROC麯線下麵積(AUC)為0.854〔95%CI (0.762,0.953)〕; GCS預測患者死亡的靈敏度為74%,特異度為87%, AUC為0.873〔95%CI (0.783,0.953)〕; APACHEⅡ預測患者死亡的靈敏度為73%,特異度為83%, AUC為0.861〔95%CI (0.813,0.932)〕。各量錶預測患者死亡的AUC比較,差異均無統計學意義(P>0.05)。結論 FOUR預測STBI患者死亡的靈敏度與特異度較高,與GCS、 APACHEⅡ對STBI患者預後的評價具有同等價值。
목적:탐토전면무반응성량표(FOUR)예측중형창상성로뇌손상(STBI)환자예후적개치。방법선취2012년1월—2013년12월우흠주시제이인민의원치료적STBI ( GCS평분≤8분)환자95례위연구대상,근거입원28 d내시부발생사망(포괄뇌사망),장환자분위사망조(37례)화존활조(58례)。수집환자림상자료,포괄성별、년령、로뇌손상원인급시부수술치료;유동일연구자재환자입원24 h내대기진행FOUR、 GCS급APACHEⅡ평개。결과사망조년령、 APACHEⅡ평분고우존활조, FOUR、 GCS평분저우존활조( P<0.01)。 FOUR예측환자사망적령민도위72%,특이도위85%, ROC곡선하면적(AUC)위0.854〔95%CI (0.762,0.953)〕; GCS예측환자사망적령민도위74%,특이도위87%, AUC위0.873〔95%CI (0.783,0.953)〕; APACHEⅡ예측환자사망적령민도위73%,특이도위83%, AUC위0.861〔95%CI (0.813,0.932)〕。각량표예측환자사망적AUC비교,차이균무통계학의의(P>0.05)。결론 FOUR예측STBI환자사망적령민도여특이도교고,여GCS、 APACHEⅡ대STBI환자예후적평개구유동등개치。
Objective To explore the value of Full Outline of Unresponsiveness Scale ( FOUR Scale ) in the prediction of death of patients with severe traumatic brain injury ( STBI) .Methods We enrolled 95 patients with STBI ( GCS score≤8) who received treatment in the Second People′s Hospital of Qinzhou from January 2012 to December 2013.According to whether death ( including brain death ) occurred within 28 days after admission , the subjects were divided into two groups:death group (n=37) and survival group (n=58).Clinical data were collected, including gender, age, reason for brain injury and undergoing surgery or not .The same researcher made FOUR , GCS and APACHEⅡevaluations on the patients within 24 hours after admission.Results The death group was higher (P<0.01) in age and APACHEⅡ score and lower (P<0.01) in FOUR score and GCS score than the survival group .The sensitivity degree and specificity degree of FOUR predicting death were 72%and 85%, with an AUC of 0.854 〔95%CI (0.762, 0.953)〕; the sensitivity degree and specificity degree of GCS predicting death were 74% and 87%, with an AUC of 0.873 〔95%CI ( 0.783, 0.953 )〕; the sensitivity degree and specificity degree of APACHEⅡpredicting death were 73% and 83%, with an AUC of 0.861 〔95%CI (0.813, 0.932)〕. No significant difference was noted among the three scales in the prediction of death (P>0.05).Conclusion FOUR Scale has high sensitivity degree and specificity degree in predicting the death of STBI patients , thus it has equal predictive value with GCS and APACHEⅡin the prognosis of STBI patients .