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目的:对改良早期预警评分、APACHE-Ⅱ与SIRS对颅脑外伤患者预后评估的价值进行比较。方法:研究对象为我院急诊收入院的颅脑外伤患者269例,死亡71例作为死亡组、存活198例作为存活组。患者入院后24h内的临床资料分别采用MEWS、APACHE-Ⅱ与SIRS进行评分。采用ROC曲线对MEWS、APACHE-Ⅱ与SIRS的评估效果进行分析,比较曲线下面积。结果:死亡组MEWS、APACHE-Ⅱ与SIRS(8.24±1.70)、(29.03±5.72)、(2.4±0.6)分均高于存活组(2.26±0.93)、(9.25±6.08)、(1.0±0.3)分,比较差异有统计学意义(P<0.05)。死亡组MEWS、APACHE-Ⅱ与SIRS评分死亡频数分布与存活组比较差异有统计学意义(P<0.05)。MEWS、APACHE-Ⅱ与SIRS的曲线下面积分别为:0.754、0.857、0.689,APACHE-Ⅱ曲线下面积大于MEWS、SIRS(P<0.05),MEWS、SIRS的曲线下面积比较差异无统计学意义(P>0.05)。结论:APACHE-Ⅱ对颅脑外伤患者预后评估的效果好于MEWS、SIRS,但MEWS收集资料更简单方便,更适用于临床。
OBJECTIVE: To compare the prognostic value of improved early warning score, APACHE-Ⅱ and SIRS in patients with craniocerebral trauma. Methods: Totally 269 patients with craniocerebral trauma were included in this study. Among them, 71 died as the dead group and 198 survived as the survival group. The clinical data of patients within 24 hours after admission were scored using MEWS, APACHE-II and SIRS respectively. The ROC curve was used to analyze the assessment of MEWS, APACHE-II and SIRS, and to compare the area under the curve. Results: The mortality of MEWS, APACHE-Ⅱ and SIRS were (8.24 ± 1.70), (29.03 ± 5.72) and (2.4 ± 0.6) points higher than those in survivals group (2.26 ± 0.93), (9.25 ± 6.08) and ) Points, the difference was statistically significant (P <0.05). Mortality group MEWS, APACHE-Ⅱ and SIRS score distribution of death frequency and survival difference was statistically significant (P <0.05). The area under the curve of MEWS, APACHE-Ⅱand SIRS were 0.754,0.857,0.689 respectively, the area under the curve of APACHE-Ⅱ was greater than that of MEWS and SIRS (P <0.05), and the area under the curve of MEWS and SIRS was not statistically significant P> 0.05). Conclusion: APACHE-Ⅱ is better than MEWS and SIRS in assessing the prognosis of patients with traumatic brain injury. However, MEWS is more simple and convenient to collect data and is more suitable for clinical application.