严重创伤综合评估方法的研究进展

Research progress on comprehensive evaluation methods of severe trauma

使用综合评分预测生存概率(Ps)在现代创伤系统中起着关键作用,所有严重创伤患者的Ps都应该被准确评估。然而,Ps评估方法在不同国家的创伤机构并不统一。德国修正的损伤严重程度分类-Ⅱ(RISCⅡ)和英国的Ps模型-14(Ps-14)均基于大样本的最新数据库,更适用于欧洲人群的创伤评估。经过更新修订的纠正创伤和严重损伤评分(TRISS)来源于美国国家数据库,是预测结局的全球标准,但对以钝性伤为主的创伤评估不够准确。为弥补TRISS评分不足而修定的严重创伤特征评分(ASCOT)理论上预测价值更精确。而其他的一些综合评分也有较高预测价值,现将各种综合评估方法作综述如下。

The application of comprehensive score in the probability of survival（Ps） plays a key role in the modern trauma system.Ps in all severely trauma patients should be accurately assessed.However,the method for assessing Ps is not uniform among the trauma agencies in different countries.Germany′s revised injury severity classification-Ⅱ（RISCⅡ） and UK′s Ps-14 are based on the latest database of large samples and are more suitable for the trauma evaluation for European population.The updated and modified trauma and injury severity score（TRISS） is derived from the United States national database,which is the global standard for predicting outcome.However,trauma assessment based on blunt trauma is not accurate enough.A severity characterization of trauma（ASCOT） which is revised to make up for the lack of TRISS scores is theoretically more accurate in the value of prediction.Other comprehensive scores also have higher predictive values.The comprehensive evaluation methods are summarized as follows.