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两种卒中筛查量表在脑卒中院前急救筛查中的应用价值分析

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目的 探讨两种卒中筛查量表在脑卒中院前急救筛查中的应用价值。方法 202例通过急诊卒中绿色通道接诊的疑似脑卒中患者，按照院前急救中所选取的卒中筛查量表不同分为研究组和对照组，各 101 例。对照组采用辛辛那提院前卒中量表(CPSS)进行评估，研究组采用改良洛杉矶院前卒中筛查量表(MLAPSS)进行评估。以入院后神经专科医师意见及影像学检查作为最终诊断结果，比较两组筛查量表诊断时间、从呼救到治疗时间，不同筛查量表的诊断结果及诊断效能。结果 全部患者经院前急救入院后，参考医生和影像学检查的诊断结果，发现对照组中有 67 例脑卒中患者，有 34 例非脑卒中患者;研究组中有 72 例脑卒中患者，有 29 例非脑卒中患者。研究组患者的筛查量表诊断时间以及从呼救到治疗时间比对照组稍长，但两组比较无统计学意义(P>0。05)。CPSS共筛查出脑卒中患者 58 例，非脑卒中患者 43 例。MLAPSS共筛查出脑卒中患者 69 例，非脑卒中患者 32 例。MLAPSS的准确度 87。13%、灵敏度 88。89%均高于CPSS的 75。25%、74。63%，漏诊率 11。11%低于CPSS的 25。37%，差异存在统计学意义(P<0。05);两种筛查量表的特异度、误诊率比较无统计学意义(P>0。05)。结论 在院前急救中筛查脑卒中疾病，CPSS和MLAPSS均有较高的临床价值，两种筛查量表比较，MLAPSS对脑卒中疾病的筛查价值更高，值得推广。
Application value of two stroke screening scales in pre-hospital emergency screening for stroke
Objective To explore the application value of two stroke screening scales in pre-hospital emergency screening for stroke.Methods 202 suspected stroke patients through the emergency stroke green-channel were divided into a study group and a control group according to different stroke screening scales selected in pre-hospital emergency,each with 101 cases.The control group was evaluated by Cincinnati Prehospital Stroke Scale(CPSS),and the study group was evaluated by modifeid Los Angeles Prehospital Stroke Screen Scale(MLAPSS).With the opinion of neurologist and imaging examination after admission as the final diagnosis results,the scale screening diagnosis time and the time from calling for help to treatment,diagnostic results and diagnostic efficacy of different screening scales of the two groups were compared.Results After all patients were admitted to the hospital by prehospital emergency care,with reference to the diagnostic results of doctors and imaging tests,it was found that there were 67 stroke patients and 34 non-stroke patients in the control group,while there were 72 stroke patients and 29 non-stroke patients in the study group.The scale screening diagnosis time and the time from calling for help to treatment of the research group were a little longer than those of the control group,but there was no statistical significance(P>0.05).A total of 58 stroke patients and 43 non-stroke patients were screened by CPSS.A total of 69 stroke patients and 32 non-stroke patients were screened by MLAPSS.The accuracy of MLAPSS was 87.13%and the sensitivity was 88.89%,which were higher than 75.25%and 74.63%of CPSS;and the missed diagnosis rate of MLAPSS was 11.11%,which was lower than 25.37%of CPSS.The difference was statistically significant(P<0.05).There was no statistical significance in the specificity and misdiagnosis rate between the two screening scales(P>0.05).Conclusion Both CPSS and MLAPSS have high clinical value in screening stroke diseases in pre-hospital emergency care.Compared with the two screening scales,MLAPSS has higher screening value for stroke diseases and is worth promoting.

Stroke screening scaleStrokePre-hospital emergencyCincinnati Prehospital Stroke ScaleModifeid Los Angeles Prehospital Stroke Screen Scale

叶巧亮、傅洪宾、刘君、林舒婷

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363000 漳州市急救中心急救科

卒中筛查量表 脑卒中 院前急救 辛辛那提院前卒中量表 改良洛杉矶院前卒中筛查量表

2024

10.14164/j.cnki.cn11-5581/r.2024.03.021

中国现代药物应用
中国水利电力医学科学技术学会

中国现代药物应用

影响因子：0.862
ISSN：1673-9523
年,卷(期)：2024.18(3)
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