颌面损伤严重度评分与损伤严重度评分评估颌面创伤严重度的敏感性比较

A comparative study on sensitivity of maxillofacial injury severity score system and injury severity score system for assessment of maxillofacial trauma severity

目的对损伤严重度评分（ISS）与颌面损伤严重度评分（MFISS）进行比较，探讨二者对颌面部损伤严重度评估的可靠性与敏感性。方法应用MFISS和ISS对741例颌面部创伤进行评分，根据不同骨折数目和不同骨折部位分组统计分析。结果单纯颌面部创伤和合并全身其他部位创伤的颌面部创伤组单处骨折、两处骨折与多处骨折患者ISS和MFISS平均评分差异均有统计学意义（P〈0．01）。ISS对单处骨折与两处骨折差异无统计学意义（P〈0．01）；MFISS组间比较差异有统计学意义。全面部、面中部和面下部创伤患者在单纯颌面部创伤组ISS和MFISS分值与合并全身其他部位损伤的MFISS分值差异均有统计学意义（P〈0．01），合并全身其他部位损伤的颌面部创伤ISS分值差异无统计学意义。ISS面中部和面下部之间差异无统计学意义，且组间平均评分接近；MFISS组间比较，差异均有统计学意义（P〈0．01）。结论MFISS对颌面部创伤的程度反映较ISS评分系统更具灵敏性和特异性。

Objective To explore the reliability and sensitivity of injury severity score system （ISS） and maxillofacial injury severity score system （MFISS） for assessment of maxillofacial injury severity. Methods A total of 741 patients with maxiUofacial trauma were evaluated by using MFISS and ISS respectively. They were divided into Group A （ not accompanied by systemic injury） and Group B （ accompanied by systemic injury）, which were divided into subgroups a （single fracture）, b （2 fractures） and c （3 fractures and above） by the number of fractures and further into Subgroup d （ mandible fracture）, e （midface fracture） and f （overall prosopo-fracture） by the fracture site. Statistical analysis was done based on the classification of the groups. Results There was a significant difference between Group A and B in the mean MFISS and ISS scores （P 〈0.01 ）. No significant difference was found between subgroups a and b in the ISS score. The MFISS score of subgroups d, e and f in Groups A and B were statistically different （P 〈0. 01 ）. The ISS and MFISS of subgroups d, e, and f in Group A and MFISS of subgroups d, e, and f in Group B were statistically different between each other （ P 〈 0.01 ）. No significant difference was found between subgroups d, e and f in Group B in the ISS score, with the scores of subgroups d and e close to each other. Conclusion Compared with ISS, MFISS has a more preferable sensitivity and specificity in assessing the maxillofacial injury.