Oakland评分系统在急性下消化道出血患者中的临床应用研究

Application of Oakland scoring system in patients with acute lower gastrointestinal hemorrhage

目的探讨Oakland评分系统在急性下消化道出血患者中的临床应用价值。方法198例急性下消化道出血患者,均进行Oakland评分和Rockall评分,评价两个评分系统的应用效果。结果1个月内再出血、死亡、输血、再入院、再次内镜或放射治疗患者的Oakland评分和Rockall评分均高于未出现症状者,差异均具有统计学意义(P<0.05)。Oakland评分、Rockall评分的低危及非低危比例比较,差异无统计学意义(P>0.05)。Oakland评分系统预测再出血的曲线下面积(AUC)为0.692[95%CI=(0.66,0.75),P<0.05],预测死亡的AUC为0.741[95%CI=(0.69,0.81),P<0.05]。Rockall评分系统预测再出血的AUC为0.701[95%CI=(0.67,0.78),P<0.05],预测死亡的AUC为0.752[95%CI=(0.68,0.79),P<0.05]。结论Oakland评分系统与Rockall评分系统的临床指导价值一致,可用于临床急性下消化道出血患者治疗指导及预后评估,提升资源利用率。

Objective To discuss the clinical value of Oakland scoring system in patients with acute lower gastrointestinal hemorrhage.Methods A total of 198 patients all received Oakland score and Rockall score to evaluate the practical effects of the two scoring systems.Results The Oakland score and Rockall score of patients with rehemorrhage,death,blood transfusion,readmission,re-endoscopic or radiotherapy within 1 month were higher than those of patients without symptoms,and the differences were statistically significant(P<0.05).There was no statistically significant difference between the low-risk and non-low-risk ratios of Oakland score and Rockall score(P>0.05).The area under the curve(AUC)of Okland scoring system for predicting rehemorrhage was 0.692[95%CI=(0.66,0.75),P<0.05],and AUC of predicting death was 0.741[95%CI=(0.69,0.81),P<0.05].The AUC of Rockall scoring system for predicting rehemorrhage was 0.701[95%CI=(0.67,0.78),P<0.05],and AUC of predicting death was 0.752[95%CI=(0.68,0.79),P<0.05].Conclusion The clinical guidance value of Oakland scoring system is consistent with Rockall scoring system,which can be used for clinical treatment guidance and prognosis evaluation of patients with acute lower gastrointestinal hemorrhage,and improve the utilization rate of resources.