改良颌面损伤严重度评分用于颧骨骨折伤度分析的初步研究

目的 通过对颧骨骨折临床病例资料的回顾分析,探讨改良颌面损伤严重度评分(RFISS)初步用于颧骨骨折伤度评价的可行性.方法 采用损伤严重度评分(ISS)和改良损伤严重度评分(RFISS)对202例颧骨骨折患者进行分析,比较两种方法应用于颧骨骨折严重度评分的可行性和实用性.结果 两种方法对颧骨骨折伤度进行评分,结果显示多处伤组的RFISS值高于ISS值(P＜0.01);单纯颧弓骨折和单纯颧骨骨折RFISS与ISS评分差异无显著性(P＞0.01);颧骨颧弓骨折和颧骨复合体骨折RFISS与ISS评分差异有显著性(P＜0.01);交通伤组和其他伤组的损伤严重度比较,RFISS法显示交通伤的伤情重于其他伤的伤情(P＜0.01),而ISS却未能表示出以上差异(P＞0.01).结论 对于评价颧骨骨折损伤严重程度,RFISS在不违背AIS基本原则和不改变AIS-ISS函数关系的的情况下,在区分颧骨骨折伤情严重度方面优于ISS.功能损伤评价的加入将违背AIS的基本原则和函数关系,并且影响创伤评分的准确性.

Preliminary study of revised injury severity score on evaluation of severity of zygomatic fractures

Objective To evaluate a new trauma severity score system(revised facial injury severity score,RFISS)on the severity of the zygomatic fracture.Methods A total of 202 cases of zygomatic fractures were selected and evaluated with ISS and RFISS respectively. The results of ISS and RFISS were compared and analyzed with SPSS software.ResultsRFISS could accurately differentiate between single and multiple zygomatic fracture. It also could differentiate the traffic injury severity from other injuries. Although there was no significant difference in simple zygomatic fractures and simple arch fractures between RFISS and ISS, there was difference in zygomatic body and arch fractures and zygomatic complex fractures between the two score systems. Conclusion FISS is more sensitive and meaningful for evaluating different sites of zygomatic fractures than ISS. RFISS can be used to evaluate zygomatic fracture objectively and accurately. Function loss should not be included in the injury severity scale.