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修订版昏迷恢复量表在脑卒中气管切开患者拔管中的应用

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目的 探讨修订版昏迷恢复量表(CRS-R)对脑卒中气管切开患者拔管的预测价值.方法 收集 2019 年1月至 2023 年12 月扬州大学建湖临床医学院康复中心收治的129 例脑卒中气管切开患者的临床资料.以入康复中心30、90 d时是否拔管将患者分为未拔管组、成功拔管组,分析两组的一般资料;评价格拉斯哥昏迷量表(GCS)、CRS-R评分对脑卒中气管切开患者拔管的预测价值.结果 129 例脑卒中气管切开患者中,入康复中心 30d时 54 例(41.9%)患者成功拔管,入康复中心 90d时 82 例(63.6%)患者成功拔管;入康复中心 30、90 d时,两组的脑卒中病史及GCS、CRS-R评分比较,差异具有统计学意义(P<0.05).入康复中心30、90 d时,GCS、CRS-R评分预测拔管的曲线下面积(AUC)比较,差异具有统计学意义(P<0.001);入康复中心30、90 d时,CRS-R评分预测拔管的最佳截断值分别为 10.5、6.5 分.结论 GCS、CRS-R评分对拔管有一定预测价值,且CRS-R评分优于GCS评分.
Application of the Coma Recovery Scale-Revised in decannulation of patients with tracheotomy after stroke
Objective To investigate the predictive value of the Coma Recovery Scale-Revised(CRS-R)in decannulation of patients with tracheotomy after stroke.Methods The clinical data of 129 patients with tracheotomy after stroke admitted in the rehabilitation center of Jianhu Clinical Medical College,Yangzhou University from January 2019 to December 2023 were collected.All patients were divided into non-decannulation group and successful decannulation group according to whether decannulation was performed at 30 and 90 d after admission to the rehabilitation center.The general data of the two groups were analyzed;the predictive value of Glasgow Coma Scale(GCS)and CRS-R scores for decannulation in patients with tracheotomy after stroke were evaluated.Results Among the 129 patients with tracheotomy after stroke,54 patients(41.9%)had successfully decannulation at 30 d after admission to the rehabilitation center,and 82 patients(63.6%)had successfully decannulation at 90 d after admission to the rehabilitation center;at 30 and 90 d after admission to the rehabilitation center,there were statistically significant differences in stroke history,GCS and CRS-R scores between the two groups(P<0.05).At 30 and 90 d after admission to the rehabilitation center,there were statistically significant differences in the area under curve(AUC)of GCS and CRS-R scores for predicting decannulation(P<0.001);the optimal cut-off values of CRS-R score for predicting decannulation were 10.5 and 6.5 points at 30 and 90 d after admission to the rehabilitation center,respectively.Conclusion GCS and CRS-R scores have certain predictive value for decannulation,and CRS-R score is better than GCS score.

stroketracheostomydecannulationComa Recovery Scale-Revised

戚婷、陈琛、王崇、刘冬

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扬州大学医学院,江苏 扬州,225009

盱眙县人民医院神经内科,江苏 淮安,211700

扬州大学建湖临床医学院神经内科,江苏 盐城,224700

脑卒中 气管切开 拔管 修订版昏迷恢复量表

2024

临床医学研究与实践

临床医学研究与实践

ISSN:
年,卷(期):2024.9(34)
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