儿童严重创伤评估工具的研究进展

Assessment Tools for Severe Trauma in Children:a Literature Review

创伤评分是对创伤生理、解剖结构、损伤机制及相关并发症等进行定量评估,在预测结果的准确性和计算分数的便利性之间取得平衡。文章就基于生理学、解剖学及两者综合评估工具等三方面对儿童严重创伤常用评估工具的内容、使用现状及存在的优缺点进行综述。目前格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)是评估意识损伤程度的理想工具,是研究最充分的神经系统评分。儿童年龄调整休克指数(pediatric age-adjusted shock index,SIPA)考虑儿童不同年龄段存在的生理差异,其简便、可反复动态评估血流动力学状态。损伤严重程度评分(injury severity score,ISS)是应用较广泛的损伤严重程度评估工具。儿童创伤评分(pediatric trauma score,PTS)是专为儿童开发的院内院外创伤评分,计算简便。严重创伤病情复杂,当前存在多种创伤评估工具,每种工具都有其优势与局限,可联合应用动态评估创伤患儿病情。

Trauma scoring is a quantitative evaluation of trauma physiology,anatomical structure,injury mechanisms,and related complications,balancing the accuracy of prediction results with the convenience of calculating scores.This article provides a review of contents,current usage status,and advantages and disadvantages of commonly used assessment tools for severe trauma in children,based on physiology,anatomy,and their comprehensive evaluation tools.At present,Glasgow Coma Scale(GCS)is an ideal tool for assessing the degree of consciousness impairment and is the most extensively studied neurological scoring system.Pediatric Age-adjusted Shock Index(SIPA)takes into account physiological differences among children of different age groups,making it simple and repeatable for dynamically assessing hemodynamic status.Injury Severity Score(ISS)is a widely used tool for assessing the severity of damage.Pediatric Trauma Score(PTS)is an in-hospital and out-of-hospital trauma scoring developed specifically for children and is easy to calculate.The severity of severe trauma in children is rather complex,and there are currently multiple trauma assessment tools available,each with its advantages and limitations,which can be combined to dynamically evaluate the conditions of children with trauma.