AIS-ISS创伤评分、脑损伤指数对颅脑损伤患者预后自理能力的评估价值-现代医学

AIS-ISS创伤评分、脑损伤指数对颅脑损伤患者预后自理能力的评估价值

单位：1. 承德医学院附属医院神经外科, 河北承德 067000;
2. 承德医学院附属医院营养科, 河北承德 067000

分类号：R651.15

出版年·卷·期（页码）：2019·47·第五期（526-530）

摘要：

目的：探讨AIS-ISS创伤评分与脑损伤指数（craniocerebral injury index，CCⅡ）对颅脑损伤患者出院6个月自理能力的评估价值。方法：回顾性分析132例颅脑损伤患者的临床资料，根据患者出院6个月的远期生活质量评估评分（Karnofsky performance scale，KPS）将患者分为自理能力好组（KPS 51~100分）和自理能力差组（KPS 0~50分），分析患者入院时的AIS-ISS创伤评分和CCⅡ与KPS的相关性，绘制两种评分的受试者工作特征曲线（area under the receiver-operating characteristic curve，ROC），计算曲线下面积，根据敏感度和特异度确定评估标准。结果：入院时的CCⅡ自理能力好组高于自理能力差组，AIS-ISS值自理能力好组低于自理能力差组，差异均有统计学意义（P<0.05）。CCⅡ与出院6个月KPS呈正相关（r=0.597，P<0.01），AIS-ISS创伤评分与出院6个月的KPS呈负相关（r=-0.627，P<0.01）。CCⅡ和AIS-ISS创伤评分预测颅脑损伤患者出院6个月KPS的ROC曲线下面积分别为0.748和0.802；患者入院时CCⅡ ≥ 2.5或AIS-ISS创伤评分≤ 14.5分时，患者出院6个月的自理能力较好。结论：入院时AIS-ISS创伤评分和CCⅡ对颅脑损伤患者出院6个月KPS均有预测意义，但AIS-ISS创伤评分对患者出院6个月自理能力更具预测价值。

Objective:To discuss value of AIS-ISS trauma score and craniocerebral injury index(CCⅡ) on the self-help ability of patients with craniocerebral injury. Methods:132 cases of postoperative patients with craniocerebral injury were retrospectively analyzed and divided into good self-care ability group(KPS 51-100) and poor self-care ability group (KPS 0-50) according to Karnofsky performance scale(KPS). The correlation between KPS and CCⅡ, as well as AIS-ISS was analyzed; Area under the receiver-operating characteristic curve (ROC) of the two scoring methods was drawn, the area under curve was calculated, and then evaluating criteria was confirmed based on sensitivity and specificity. Results:CCⅡ of good self-care ability group was higher than that of thepoor self-care ability group,AIS-ISS was lower than that of the poor self-care ability group, the difference was statistically significant (P<0.05). There was a significant positive correlation between CCⅡ and KPS of 6 months after discharge (r=0.597, P<0.01), the AIS-ISS was negatively correlated with KPS of 6 months after discharge (r=-0.627, P<0.01). The area of the ROC curve of that CCⅡ and AIS-ISS predicting KPS of 6 months after discharge on patients with craniocerebral injury were respectively 0.748 and 0.802; the results showed when CCⅡwas ≥ 2.5 and AIS-ISS was ≤ 14.5 on admission, KPS of 6 months after discharge was better. Conclusion:AIS-ISS trauma score and CCⅡ are both predictive for KPS of 6 months after discharge on patients with craniocerebral injury, but AIS-ISS is more closely related to self-care ability and more predictive.

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