颌面损伤严重度评分的研究

比较简明损伤定级(abbreviated injury scale,AIS)2005与AIS 1998在评价颌面部损伤严重度及创伤结局的差异,探讨简明损伤定级AIS 2005的临床可行性及实用价值.方法采用AIS 2005和AIS 1998对450例颌面部创伤病例资料分别进行回顾性分析,并分为AIS 2005组(450例,A组)、AIS 1998组(450例,B组).结果损伤严重度评分(injuries severity score,ISS)值递增,两组病死率、并发症发生率均上升;当ISS>20时,A组病死率明显上升;ISS>15、ISS<20时,A组病死率较B组显著降低(P=0.001).各ISS分值段并发症发生率A组高于B组.结论 ISS评价创伤及其结局预测总体AIS 2005优于AIS 1998;AIS 2005评分标准较AIS 1998能够更加敏感地反映创伤的严重度.使用AIS 2005评价多发伤时,应以ISS>20界定严重多发伤.

Assessment of the injury severity score in evaluation of multiple maxillofacial injuries

Objective To compare the superiority of abbreviated injury scale (AIS) 2005 and AIS 1998 for evaluation of maxillofacial injury severity and major trauma outcome. Methods A total of 450 trauma patients evaluated by AIS 2005 and AIS 1998 from July 2005 to January 2007 were analyzed retrospectively. Results The mortality and morbidity of complications in trauma patients were ascending with the increase of injuries severity score (ISS). The ascending tendency in mortality was more notable in injuries severity score (ISS) > 20 in AIS 2005. The mortality in trauma patients in AIS 2005 was significantly lower than those in AIS 1998 in ISS > 15, < 20 ( P = 0.001 ). The ascending tendency to morbidity of complications was more notable in other ISS groups in AIS 2005 than those in AIS 1998. Conclusions The evaluation of injury severity and major trauma outcome by ISS based on AIS 2005 is superior to based on AIS 1998. It is reasonable to definite severe trauma by ISS value greater than 20 in AIS 2005.