【摘要】 目的探讨损伤严重程度评分(injury severity score,ISS)在老年腹部多发伤中的应用价值,为其临床应用提供依据。方法选取2016年7月—2018年6月来我院治疗的142例老年腹部多发伤患者为观察组,120例老年健康体检者为对照组。观察并比较2组的免疫学指标值情况、观察组患者ISS分值、ISS分值与免疫学指标值之间的相关性。观察组再分为死亡亚组和存活亚组,观察并比较2亚组的死亡率和ISS分值。结果 2组IgA、IgG和IgM水平无显著差异(P>0.05);观察组TNF-α水平显著高于对照组和CD4/CD8比值显著低于对照组(P<0.05)。观察组ISS分值为(38.54±5.79)分,ISS分值与TNF-α水平呈正相关(r=0.41,P<0.01);ISS分值与CD4/CD8水平呈负相关(r=-0.37,P<0.01)。观察组中有31例死亡,死亡率为21.83%;死亡亚组ISS评分显著高于存活亚组(P<0.01);ISS用于预测老年腹部多发伤患者死亡的敏感性和特异性分别为87.52%和90.31%,曲线下面积为0.907。结论损伤严重程度评分与老年腹部多发伤的感染和免疫功能具有相关性,对预测患者预后有一定的价值。更多还原

【Abstract】 Objective To explore the clinical value of injury severity scores(ISS)in multiple abdominal injuries of the elderly. Methods 142 elderly with multiple abdominal injuries hospitalized during the period from July,2016 to June,2018 were selected to be observation group while 120 elderly of physical examination to be control group; the immunological parameters of the cases in the 2 groups were observed and a comparative study was made between the 2 groups while the ISS scores and the correlation between ISS scores and immunological parameters of the cases in observation group were analyzed;observation group was further subdivided into 2 subgroups: death subgroup and survival subgroup,the mortality rates and ISS scores in the 2 subgroups were observed and compared. Results There existed no obvious statistical differences in the levels of IgA,IgG,and IgM between the 2 groups(P>0.05); the level of TNF-α was significantly higher and the ratio of CD4/CD8 was greatly lower in observation group than those in control group(P<0.05); the ISS score in observation group(38.54±5.79) was in positive correlation to the level of TNF-α(r=0.41,P <0.01) while in negative correlation to the level of CD4/CD8(r=-0.37,P<0.01); 31 cases died in observation group,the mortality rate was 21.83%; the ISS scores in death subgroup were much higher than those in survival subgroup(P<0.01); the sensitivity of ISS scores in predicting death in the elderly with multiple abdominal injuries was 87.52%,the specificity was 90.31%,and the area under the curve was 0.907.Conclusions ISS score is correlated to the infection of multiple abdominal injuries and immunological function in the elderly and is of certain value in predicting the prognosis.更多还原