摘要
目的比较婴幼儿神经创伤评分(TINS)、Marshall CT分级、Rotterdam CT评分和Helsinki CT评分对婴幼儿(≤3岁)颅脑创伤患者预后的预测价值。方法选择2012年1月至2017年12月诊治的婴幼儿颅脑创伤患者共37例,创伤后6个月采用Glasgow预后分级(GOS)评价预后,TINS评分、Marshall CT分级、Rotterdam CT评分和Helsinki CT评分预测预后,绘制受试者工作特征曲线(ROC)并计算曲线下面积,并比较4种评分系统对婴幼儿颅脑创伤患者预后的预测价值。结果创伤后6个月恢复良好(GOS分级5级)者19例(51.35%)、轻残(GOS分级4级)11例(29.73%)、重残(GOS分级3级)6例(16.22%)、死亡(GOS分级1级)1例(2.70%)。ROC曲线显示,创伤后6个月TINS评分、Marshall CT分级、Rotterdam CT评分和Helsinki CT评分预测预后不良(GOS评分1~3分)的曲线下面积分别为0.774(95%CI:0.539~1.000,P=0.026)、0.807(95%CI:0.668~0.946,P=0.012)、0.748(95%CI:0.535~0.960)TINS评分、Marshall CT分级、Rotterdam CT评分和Helsinki CT分级系统对婴幼儿颅脑创伤远期预后均有较好的预测价值,尤以Marshall CT分级对创伤后6个月预后的预测更具优势。
Objective To compare the predictive efficiency of different scoring systems including Trauma Infant Neurologic Score(TINS),Marshall CT score,Rotterdam CT score and Helsinki CT score for the long-term prognosis of infant(≤3 years old) traumatic brain injury(TBI).Methods Clinical records and imaging data of 37 cases with infant TBI(admitted to Department of Neurosurgery,Xiangya Hospital,Central South University from January 2012 to December 2017) were analyzed retrospectively.Glasgow Outcome Scale(GOS) was used to evaluate the prognosis 6 months after TBI.TINS score,Marshall CT score,Rotterdam CT score and Helsinki CT score were used to predict the prognosis.The Receiver Operating Characteristics Curve(ROC) comparing among TINS,Marshall CT,Rotterdam CT and Helsinki CT scores was performed to predict the prognosis of infant TBI.Results Among 37 cases,19 cases(51.35%) had good prognosis(GOS grade 5),11 cases(29.73%) had slight disability(GOS grade 4),6 cases(16.22%) had severe disability(GOS grade 3),and one case(2.70%) died(GOS grade 1).The areas under the curve(AUC) of the TINS,Marshall CT,Rotterdam CT and Helsinki CT scores at 6-month after injury in GOS grade 1-3 group were 0.774(95% CI:0.539-1.000,P=0.026),0.807(95% CI:0.668-0.946,P=0.012),0.748(95% CI:0.535-0.960,P=0.044) and 0.740(95% CI:0.533-0.948,P=0.050),respectively.Conclusions TINS,Marshall CT,Rotterdam CT and Helsinki CT scores have good evaluation efficiency on the prognosis of infant TBI in long-term.In comparison,Marshall CT score is more advantageous in evaluating the prognosis of infant TBI 6 months after discharge.
作者
向忠豪
陈鑫
陈益磊
吴昀
兰松
罗湘颖
毕长龙
刘劲芳
XIANG Zhong⁃hao;CHEN Xin;CHEN Yi⁃lei;WU Yun;LAN Song;LUO Xiang⁃ying;BI Chang⁃long;LIU Jin⁃fang(Department of Neurosurgery,Xiangya Hospital,Central South University,Changsha 410008,Hu'nan,China)
出处
《中国现代神经疾病杂志》
CAS
北大核心
2020年第7期614-619,共6页
Chinese Journal of Contemporary Neurology and Neurosurgery
基金
湖南省卫生健康委科研计划课题(项目编号:B2019191)
湖南省卫生计生委科研计划课题(项目编号:C20180784)
