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目的:分析Glasgow昏迷分级(GCS)中运动评分与重型颅脑外伤(severe traumatic brain injury,sTBI)患者死亡率及愈合结果之间的关系,探讨运动评分应用于院前评估的可靠性。方法:回顾性分析sTBI患者出院病历,统计患者到达急诊室时的GCS评分。预后指标包括ICU死亡率,存活者(生存时间超过1个月)ICU时间、出院时的Glas-gow结果分级(GOS)、伤后第6个月的GOS。结果:本组患者共140例,65例(46.4%)在ICU治疗期间死亡,入院时总GCS评分及睁眼、言语和运动评分与ICU死亡率之间均存在显著性相关,评分越低,死亡率越高,其中最为相关的是总GCS、运动评分。生存时间超过1个月的患者中,运动评分与出院时GOS和伤后第6个月GOS之间均存在显著性相关,评分越高,愈合结果越好。结论:GCS中运动评分与sTBI患者死亡率和愈合结果之间存在显著性相关,可以替代总GCS,作为院前评估指标。
OBJECTIVE: To analyze the relationship between motor score and mortality in patients with severe traumatic brain injury (sTBI) in Glasgow coma scale (GCS) and to investigate the reliability of motor score in prehospital evaluation. Methods: A retrospective analysis of sTBI patients discharged from hospital records, statistics of patients reached the emergency room when the GCS score. Prognostic criteria included ICU mortality, ICU duration for survivors (survival over 1 month), Glas-gow outcome at discharge (GOS), and GOS 6 months after injury. Results: A total of 140 patients (65.4%) died during the intensive care unit (ICU) treatment. There was a significant correlation between total GCS score, eyes open, verbal and motor scores and ICU mortality at admission. The lower the score, The higher the mortality rate, the most relevant of which is the total GCS, exercise score. Among patients who survived more than one month, there was a significant correlation between motor score and GOS at discharge and GOS at 6 months after injury. The higher the score, the better the healing result. CONCLUSION: There is a significant correlation between motor score and mortality and healing outcome in patients with sTBI, which can replace the total GCS as a pre-hospital evaluation index.