摘要
目的分析临床症状、BIG评分、实验室检查结果等与儿童中重度创伤性颅脑损伤(TBI)预后的关系,确定预后不良相关的指标,为中重度TBI患儿预后进行早期判断。方法2022年1月至2023年1月收入江西省儿童医院PICU的中重度TBI患儿78例,收集临床资料、实验室检查、BIG评分,随访患儿6个月后的预后情况。根据格拉斯哥预后评分分为预后差组(1~3分)和预后好组(4~5分),选出与预后不良相关的指标,分析并比较指标预测TBI预后的效能。结果两组患儿在BIG评分、血红蛋白、血乳酸、血糖、合并呼吸衰竭比例、合并低血压休克比例比较差异有统计学意义(P<0.05)。BIG评分是预后不良的独立危险因素。在单一指标中比较,BIG评分AUC值(0.820)最大。在总体上比较,联合指标(BIG评分、血红蛋白、血乳酸、血糖)的AUC值(0.851)比单一指标更大,预测中重度TBI患儿预后不良的能力比单一指标更好。结论BIG评分是中重度TBI患儿早期预后的独立预测因子。联合使用BIG评分、血红蛋白、血乳酸、血糖预测儿童中重度TBI预后的能力优于单一指标。
Objective To analyze the relationship between clinical symptoms,BIG score,laboratory examination and the prognosis of children with moderate to severe traumatic brain injury(TBI),to determine the indicators associated with poor prognosis,in order to make early judgment for the prognosis of children with moderate to severe TBI.Methods A total of 78 children with moderate to severe TBI were enrolled in the PICU of Jiangxi Provincial Children's Hospital from January 2022 to January 2023.Clinical data,laboratory tests,BIG scores and Glasgow prognostic score were collected upon admission.The patients were followed up for 6 months and divided into poor prognosis group(Glasgow prognostic score1-3)and good prognosis group(Glasgow prognostic score4-5)based on the Glasgow prognostic score.The indicators related to poor prognosis were selected,and the efficacy of the indicators to predict the prognosis was analyzed and compared.Results There were statistical differences among BIG score,hemoglobin,lactic acid,glucose,respiratory failure,and hypotension shock(P<0.05).The BIG score was an independent risk factor for a poor prognosis.The BIG score had the highest AUC value(0.820)among the four indices.The combined indices(BIG score,hemoglobin,lactic acid,glucose)had the highest AUC value(0.851)and had better performance for predicting the prognosis of moderate to severe TBI in children than any of the four indexs alone.Conclusion The BIG score can be an independent predictor of early outcome in children with moderate to severe TBI.The combination of BIG score,hemoglobin,lactic acid,and glucose has better performance for predicting the prognosis of moderate to severe TBI in children than any of the four indices alone.
作者
陈媛媛
饶小平
邬涛
吴卫萍
朱友荣
Chen Yuanyuan;Rao Xiaoping;Wu Tao;Wu Weiping;Zhu Yourong(Department of PICU,Jiangxi Provincial Children's Hospital,Nanchang 330006,China)
出处
《中国小儿急救医学》
2025年第10期769-772,共4页
Chinese Pediatric Emergency Medicine
基金
江西省卫生健康委科技计划(202211196)。
