NF实验室危险指标评分、SIARI评分、坏死性软组织感染评分诊断坏死性筋膜炎效能评估

Evaluation of the efficacy of LRINEC score,SIARI score,and NSTI assessment score in the diagnosis of necrotizing fasciitis

目的评估NF实验室危险指标(LRINEC)评分、SIARI评分、坏死性软组织感染评分(NAS)诊断坏死性筋膜炎的效能。方法回顾性分析50例坏死性筋膜炎患者的临床资料(坏死性筋膜炎组),选取同期收治的102例蜂窝织炎患者为蜂窝织炎组。分析坏死性筋膜炎的临床特征,对比两组患者的临床资料,评估LRINEC评分、SIARI评分、NAS评分对两组患者的诊断效能。结果两组患者的发病部位、吸烟史、糖尿病病史、呼吸、白细胞、血红蛋白、血钠、血肌酐、尿素、血糖、C-反应蛋白、部分凝血活酶时间及住院时间比较,差异有统计学意义(P<0.05)。坏死性筋膜炎组在LRINEC评分、NAS评分方面明显高于蜂窝织炎组,差异有统计学意义(P<0.05),而两组的SIARI评分比较,差异无统计学意义(P>0.05)。结论LRINEC评分、NAS评分诊断坏死性筋膜炎和蜂窝织炎时有一定价值,但在最佳诊断临界值方面应降低标准以提升诊断效能。SIARI评分诊断坏死性筋膜炎和蜂窝织炎的效能较低。

Objective To evaluate the efficacy of LRINEC score,SIARI score,and NAS score in the diagnosis of necrotizing fasciitis.Methods The clinical data of 50 patients with necrotizing fasciitis(necrotizing fasciitis group)were retrospectively analyzed,and 102 patients with cellulitis admitted during the same period were selected as the cellulitis group.The clinical features of necrotizing fasciitis were analyzed,and the clinical data of the two groups were compared to evaluate the diagnostic efficacy of LRINEC score,SIARI score and NAS score for the two groups of patients.Results There were statistically significant differences in predilection site,smoking history,diabetes history,respiration,white blood cells,hemoglobin,sodium,creatinine,urea,blood glucose,C-reactive protein,partial thromboplastin time and hospital stay between the two groups(P<0.05).The LRINEC score and NAS score in necrotizing fasciitis group were significantly higher than those in cellulitis group,with statistical significance(P<0.05),but there was no statistical significance in SIARI score between the two groups(P>0.05).Conclusion LRINEC score and NAS score have certain value in diagnosing necrotizing fasciitis and cellulitis,but the standard should be lowered in terms of the optimal diagnostic threshold to improve diagnostic efficiency.The SIARI score has a lower efficacy in diagnosing necrotizing fasciitis and cellulitis.