中国全科医学
中國全科醫學
중국전과의학
Chinese General Practice
2015年
26期
3208-3210
,共3页
汪正光%张牧城%黄嵘%洪曦菲%方向群
汪正光%張牧城%黃嶸%洪晞菲%方嚮群
왕정광%장목성%황영%홍희비%방향군
颅脑损伤%格拉斯哥昏迷量表%全面无反应性量表%预后%重症监护病房
顱腦損傷%格拉斯哥昏迷量錶%全麵無反應性量錶%預後%重癥鑑護病房
로뇌손상%격랍사가혼미량표%전면무반응성량표%예후%중증감호병방
Craniocerebral trauma%Glasgow coma scale%Full outline of unresponsiveness%Prognosis%Intensive care units
目的：探讨全面无反应性量表（ FOUR）评分对颅脑损伤患者90 d预后的评估价值。方法选择皖南医学院附属黄山市人民医院重症医学科（ICU）2014年1—10月收治的颅脑损伤患者为研究对象进行前瞻性研究，分别评估每例患者入ICU第1天时FOUR评分和格拉斯哥昏迷量表（ GCS）评分。以入ICU第1天为观察起点，入ICU第90天为观察终点，统计患者90 d病死率，分析FOUR评分和GCS评分与改良Rankin量表（ mRS）评分之间的关系。结果51例患者纳入本研究，其中男41例、女10例，年龄21~83岁，中位年龄51（41，62）岁，中位住ICU时间8（3，15）d。90 d病死率为39.2%（20/51），90 d预后良好17例，预后不良34例。患者入ICU第1天GCS评分平均（6.5±3.6）分，FOUR评分平均（6.2±4.7）分。GCS评分与FOUR评分评估颅脑损伤患者90 d死亡风险的ROC曲线下面积分别为0.887〔95%CI（0.799，0.976），P <0.001〕和0.927〔95%CI（0.853，1.000），P <0.001〕。FOUR评分与mRS评分呈负相关（rs =-0.836，P<0.001）；GCS评分与mRS评分呈负相关（rs =-0.783， P<0.001）。结论 FOUR对颅脑损伤患者90 d预后有较好的判断价值，优于GCS评分。
目的：探討全麵無反應性量錶（ FOUR）評分對顱腦損傷患者90 d預後的評估價值。方法選擇皖南醫學院附屬黃山市人民醫院重癥醫學科（ICU）2014年1—10月收治的顱腦損傷患者為研究對象進行前瞻性研究，分彆評估每例患者入ICU第1天時FOUR評分和格拉斯哥昏迷量錶（ GCS）評分。以入ICU第1天為觀察起點，入ICU第90天為觀察終點，統計患者90 d病死率，分析FOUR評分和GCS評分與改良Rankin量錶（ mRS）評分之間的關繫。結果51例患者納入本研究，其中男41例、女10例，年齡21~83歲，中位年齡51（41，62）歲，中位住ICU時間8（3，15）d。90 d病死率為39.2%（20/51），90 d預後良好17例，預後不良34例。患者入ICU第1天GCS評分平均（6.5±3.6）分，FOUR評分平均（6.2±4.7）分。GCS評分與FOUR評分評估顱腦損傷患者90 d死亡風險的ROC麯線下麵積分彆為0.887〔95%CI（0.799，0.976），P <0.001〕和0.927〔95%CI（0.853，1.000），P <0.001〕。FOUR評分與mRS評分呈負相關（rs =-0.836，P<0.001）；GCS評分與mRS評分呈負相關（rs =-0.783， P<0.001）。結論 FOUR對顱腦損傷患者90 d預後有較好的判斷價值，優于GCS評分。
목적：탐토전면무반응성량표（ FOUR）평분대로뇌손상환자90 d예후적평고개치。방법선택환남의학원부속황산시인민의원중증의학과（ICU）2014년1—10월수치적로뇌손상환자위연구대상진행전첨성연구，분별평고매례환자입ICU제1천시FOUR평분화격랍사가혼미량표（ GCS）평분。이입ICU제1천위관찰기점，입ICU제90천위관찰종점，통계환자90 d병사솔，분석FOUR평분화GCS평분여개량Rankin량표（ mRS）평분지간적관계。결과51례환자납입본연구，기중남41례、녀10례，년령21~83세，중위년령51（41，62）세，중위주ICU시간8（3，15）d。90 d병사솔위39.2%（20/51），90 d예후량호17례，예후불량34례。환자입ICU제1천GCS평분평균（6.5±3.6）분，FOUR평분평균（6.2±4.7）분。GCS평분여FOUR평분평고로뇌손상환자90 d사망풍험적ROC곡선하면적분별위0.887〔95%CI（0.799，0.976），P <0.001〕화0.927〔95%CI（0.853，1.000），P <0.001〕。FOUR평분여mRS평분정부상관（rs =-0.836，P<0.001）；GCS평분여mRS평분정부상관（rs =-0.783， P<0.001）。결론 FOUR대로뇌손상환자90 d예후유교호적판단개치，우우GCS평분。
Objective To explore the value of the Full Outline of Unresponsiveness( FOUR)scale in the prediction of 90-day prognosis of patients with traumatic brain injury. Methods In this prospective study, we enrolled patients with traumatic brain injury who were admitted into the Intensive Care Unit( ICU)of Huangshan City People′s Hospital from January to October 2014. On 1st day after admission into ICU,every patient was evaluated by FOUR and Glasgow Coma Scale( GCS). The 90 d mortality was recorded,with the 1st day in ICU as the start and the 90th day in ICU as the end. The relations between FOUR and mRS score and between GCS score and mRS score were investigated. Results We included 51 patients,of which 41 were males and 10 were females. The age range was 21-83,the median age was 51(41,62),and the median length of ICU stay was 8(3,15)days. The 90 d mortality was 39. 2%(20/51),17 patients had favorable 90 d prognosis,and 34 patients had unfavourable 90 d prognosis. The mean GCS score on day 1 was(6. 5 ± 3. 6),and the mean FOUR score on day 1 was(6. 2 ± 4. 7). The area under the ROC curve of 90 d mortality prediction was 0. 887〔95%CI(0. 799,0. 976),P<0. 001〕for GCS score and 0. 927〔95%CI(0. 853,1. 000),P <0. 001〕for FOUR score. FOUR score and mRS score had negative correlation(rs = -0. 836,P<0. 001),and GCS score and mRS score had negative correlation(rs = -0. 783,P<0. 001). Conclusion FOUR is effective in the prediction of 90 d prognosis of patients with traumatic brain injury,and it′s superior to GCS.
