| CRAMS与APACHEⅡ评分在急诊多发伤患者伤情评价及预后评估中的应用价值 |
| 投稿时间：2018-01-18 修订日期：2018-04-04 点此下载全文 |
| 引用本文：刘莹,袁伟峰.CRAMS与APACHEⅡ评分在急诊多发伤患者伤情评价及预后评估中的应用价值[J].医学研究杂志,2018,47(12):79-82 |
| DOI：
10.11969/j.issn.1673-548X.2018.12.019 |
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| 基金项目:上海市科学技术委员会科研计划项目（16ZR1402412） |
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| 中文摘要:目的 探究CRAMS评分（circulation，respiration，abdomen，motor，speech，CRAMS）与急性生理与慢性健康评分（acute physiology and chronic health evaluation scoreⅡ，APACHEⅡ）在急诊多发伤患者伤情评价与预后评估中的应用价值。方法 以笔者医院收治的228例多发伤患者作为对象，所有患者均进行CRAMS与APACHEⅡ评分，分析CRAMS与APACHEⅡ评分与临床参数的关系，30天随访记录患者生存状况，创建受试者工作特征曲线（ROC）分析两种评分对患者死亡的预测价值。结果 228例患者中死亡41例，病死率为17.98%。CRAMS、APACHEⅡ评分与致伤部位相关（P<0.05），其中颅脑部位CRAMS评分最低，APACHEⅡ评分最高。CRAMS、APACHEⅡ评分与致伤原因无关（P > 0.05）。生存组患者CRAMS评分明显高于死亡组，APACHEⅡ评分明显低于死亡组（P<0.05）。两种评分均显示，不同病情程度组病死率比较，差异有统计学意义（P<0.05），重度组患者病死率明显高于轻、中度组（P<0.05）。ROC分析显示CRAMS评分、APACHEⅡ评分预测患者病死率的AUC值分别为0.904、0.891，两者比较差异无统计学意义（Z=0.864，P > 0.05）；APACHEⅡ评分，最佳截断值为19分，CRAMS最佳截断值为6分。结论 CRAMS与APACHEⅡ评分均在急诊多发伤患者伤情评价及预后评估中具有重要的预测价值。 |
| 中文关键词:急诊 多发伤 CRAMS评分 急性生理与慢性健康评分 预后评估 |
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| Application Value Analysis of CRAMS Score and APACHE Ⅱ in the Evaluation and Prognosis Evaluation of Emergency Multiple Trauma Patients |
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| Abstract:Objective To explore the application value of CRAMS score and acute physiology and chronic health evaluation scoreⅡ (APACHE Ⅱ) in the injury evaluation and prognosis evaluation of emergency multiple injury patients. Methods Totally 228 patients with multiple injury admitted to our hospital were selected as the objects, all the patients were given CRAMS and APACHE scores, analysis of the relationship between CRAMS and APACHE Ⅱ score and clinical parameters,30d follow-up was used to record the survival of the patients. created a receiver operating characteristic curve (ROC), and analyzed the predictive value of the two scores on the patient's death. Results Forty one of the 228 patients died, with a mortality rate of 17.98%. The scores of CRAMS and APACHE Ⅱ were correlated with the site of injury (P<0.05), the CRAMS score of the craniocerebral area was the lowest, and the APACHE Ⅱ score was the highest. The scores of CRAMS and APACHE Ⅱ were not related to the cause of injury (P>0.05). The CRAMS score in the survival group was significantly higher than that in the death group, and the APACHE Ⅱ score was significantly lower than that in the death group (P<0.05). There was significant difference between the two groups in the severity of death (P<0.05).The two scores showed that there was significant difference in mortality between different severity groups (P<0.05). The mortality in severe group was significantly higher than that in mild and moderate groups (P<0.05).The ROC analysis showed that the AUC value of CRAMS and APACHE Ⅱ scores in predicting the mortality of patients was 0.904 and 0.891 respectively, there was no significant difference between the two (Z=0.864, P>0.05); the best truncation value of APACHE Ⅱ was 19 points, the best truncation value of CRAMS was 6 points. Conclusion Both CRAMS and APACHE Ⅱ scores have important predictive value in the injury evaluation and prognosis evaluation of emergency multiple injury patients. |
| keywords:Emergency treatment Multiple injury CRAMS score Acute physiology and chronic health evaluation score Prognostic evaluation |
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