4种创伤评分评估颌面部骨折效果比较

doi:10.19438/j.cjoms.2021.04.012

中国口腔颌面外科杂志 ›› 2021, Vol. 19 ›› Issue (4): 350-353.doi: 10.19438/j.cjoms.2021.04.012

4种创伤评分评估颌面部骨折效果比较

陈晨¹, 孙宁宁², 贺洋³, 安金刚³, 巩玺³, 张益³

1.青岛大学附属医院口腔颌面外科,2.急诊重症医学科,山东青岛 266000;
3.北京大学口腔医院口腔颌面外科,北京 100081

收稿日期:2020-08-06 修回日期:2020-09-16 出版日期:2021-07-20 发布日期:2021-08-05
通讯作者: 张益,E-mail:zhangyi2000@263.net
作者简介:陈晨(1984-),男,博士研究生,主治医师, E-mail:pkuss2009@163.com

Comparative study of four trauma scoring systems to evaluate maxillofacial fractures

CHEN Chen¹, SUN Ning-ning², HE Yang³, AN Jin-gang³, GONG Xi³, ZHANG Yi³

1. Department of Oral and Maxillofacial Surgery, 2. Department of Emergency Critical Care, Affiliated Hospital of Qingdao University. Qingdao 266000, Shandong Province;
3. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology. Beijing 100081, China

Received:2020-08-06 Revised:2020-09-16 Online:2021-07-20 Published:2021-08-05

摘要/Abstract

摘要： 目的： 比较4种常用创伤评分评估颌面部骨折的效果,筛选出适合评价颌面部创伤严重程度的评分方法。方法： 收集2008年1月—2013年12月北京大学口腔医院收治的1 009例颌面部骨折患者的临床资料,骨折类型包括单纯上颌骨骨折46例,单纯下颌骨骨折536例,单纯颧骨颧弓骨折233例,复合型骨折194例。术前均采用新损伤严重度评分（NISS）、面部损伤严重度评分（FISS）、颌面部损伤严重度评分（MFISS）、颌面损伤严重度评分（MISS）进行评分。将数据导入SPSS 21.0软件包,应用非参数相关分析,计算4种评分方法与临床效应指标之间的相关系数;并以住院时间和住院费用为因变量,进行多元线性回归分析。结果： NISS对下颌骨骨折和颧骨颧弓骨折评分无统计学差异(P>0.05),FISS、MFISS、MISS对上颌骨骨折和下颌骨骨折评分无统计学差异(P>0.05)。NISS、FISS、MFISS、MISS与手术时间、麻醉费用、住院时间呈正相关,其中MFISS的相关系数最高（0.475、0.485、0.434）（P<0.05）。创伤评分和全身合并伤为住院时间和住院费用的显著影响因素,且呈正相关（P<0.05）。结论： MFISS与临床效应指标相关性最高,且显著影响住院时间和住院费用,其分值更可反映颌面部创伤的严重程度。

关键词: 颌面损伤, 面部骨折, 创伤评分, 损伤严重度评分

Abstract: PURPOSE: To select a scoring system suitable for scoring of maxillofacial trauma by comparing the effects of four commonly used trauma scoring systems. METHODS: This study cohort comprised 1 009 patients with maxillofacial trauma from January 2008 to December 2013 at Peking University School and Hospital of Stomatology. There were 46 cases with simple maxillary fractures, 536 cases with simple mandibular fractures, 233 cases with simple zygomatic arch fractures, and 194 cases with compound fractures. New Injury Severity score (NISS), Facial Injury Severity Score (FISS), Maxillofacial Injury Severity Score (MFISS), and Maxillofacial Injury Severity Score (MISS) were used to grade the injury severity of the patients before surgery. The data were imported into SPSS 21.0 software package. Correlation coefficients between the results of the four scoring systems and clinical effective indexes were calculated by non-parametric correlation analysis. Multivariate linear regression analysis was carried out with length of stay and hospitalization expenses as dependent variables. RESULTS: There was no significant difference between the score of mandibular fracture and zygomatic fracture by NISS. When FISS, MFISS, and MISS were applied, there was no significant difference between maxillary fracture scores and mandibular fracture scores(P>0.05). NISS, FISS, MFISS and MISS were positively correlated with operation time, cost of anesthesia, length of hospitalization stay, and correlation coefficients of MFISS were the highest(0.475,0.485, 0.434). The difference was statistically significant(P<0.05). Trauma score and concomitant injury were positively significant influencing factors of length of hospital stay and hospitalization expenses(P<0.05). CONCLUSIONS: MFISS showed the highest correlation with clinical effective indexes, and affected the length of hospital stay and hospitalization expenses significantly. MFISS reflected the injury severity of maxillofacial trauma better.

Key words: Maxillofacial trauma, Facial fracture, Trauma scoring, Injury severity score

中图分类号:

R782.4

陈晨, 孙宁宁, 贺洋, 安金刚, 巩玺, 张益. 4种创伤评分评估颌面部骨折效果比较[J]. 中国口腔颌面外科杂志, 2021, 19(4): 350-353.

CHEN Chen, SUN Ning-ning, HE Yang, AN Jin-gang, GONG Xi, ZHANG Yi. Comparative study of four trauma scoring systems to evaluate maxillofacial fractures[J]. China J Oral Maxillofac Surg, 2021, 19(4): 350-353.

参考文献

[1] Ahmad Z, Nouraei R, Holmes S.Towards a classification system for complex craniofacial fractures[J]. Br J Oral Maxillofac Surg, 2012, 50(6): 490-494.
[2] 张益. 我国口腔颌面创伤外科发展的思考和建议[J].中华口腔医学杂志,2008,43(11):641-645.
[3] Chen C, Zhang Y, An JG, et al.Comparative study of four maxillofacial trauma scoring systems and expert score[J]. J Oral Maxillofac Surg, 2014, 72(11): 2212-2220.
[4] Osler T, Baker SP, Long W.A modification of the injury severity score that both improves accuracy and simplifies scoring[J]. J Trauma, 1997, 43(6): 922-926.
[5] Bagheri SC, Dierks EJ, Kademani D, et al.Application of a facial injury severity scale in craniomaxillofacial trauma[J]. J Oral Maxillofac Surg, 2006, 64(3): 408-414.
[6] Zhang J, Zhang Y, El-Maaytah M, et al.Maxillofacial Injury Severity Score: proposal of a new scoring system[J]. Int J Oral Maxillofac Surg, 2006, 35(2): 109-114.
[7] 李戍军,刘彦普,石照辉,等.3种创伤严重度评分对颌面创伤评估的比较[J].解放军医学杂志,2004, 29(1): 66-68.
[8] 李祖兵,张益,刘彦普.口腔颌面创伤外科学[M].北京:人民卫生出版社,2011:68-70.
[9] Cannell H, Paterson A, Loukota R.Maxillofacial injuries in multiply injured patients[J]. Br J Oral Maxillofac Surg, 1996, 34(4): 303-308.
[10] 薄斌,顾晓明,周树夏.颌面部创伤严重度评价的改进[J].实用口腔医学杂志, 2000, 16(3): 178-180.
[11] 葛成,何黎升,顾晓明,等.改良面部损伤严重度评分法评价颌面部创伤1134例[J].中华创伤杂志, 2001, 17(5): 275-276.
[12] 薄斌,周树夏,顾晓明.AIS-ISS创伤评分法及其在颌面创伤中的应用[J].中华口腔医学杂志,2001, 36(2): 155-157.
[13] Cooter RD, David DJ.Computer-based coding of fractures in the craniofacial region[J]. Br J Plast Surg, 1989, 42(1): 17-26.
[14] Catapano J, Fialkov JA, Binhammer PA, et al.A new system for severity scoring of facial fractures: development and validation[J]. J Craniofac Surg, 2010, 21(4): 1098-1013.
[15] Yamamoto K, Matsusue Y, Horita S, et al.Clinical analysis of midfacial fractures[J]. Mater Sociomed, 2014, 26(1): 21-25.
[16] Sahni V.Maxillofacial trauma scoring systems[J]. Injury, 2016, 47(7): 1388-1392.
[17] Waterkamp V, Ricklin M, Schaller B, et al.Severity and pattern of injuries caused by the traditional Swiss team sport 'Hornussen': first retrospective study at a level I trauma centre in Switzerland[J]. BMJ Open Sport Exerc Med, 2016, 2(1): e000122.
[18] Furr AM, Schweinfurth JM, May WL.Factors associated with long-term complications after repair of mandibular fractures[J]. Laryngoscope, 2006, 116(3): 427-430.
[19] Bocchialini G, Castellani A.Facial trauma: a retrospective study of 1 262 patients[J]. Ann Maxillofac Surg, 2019, 9(1): 135-139.
[20] Ramalingam S.Role of maxillofacial trauma scoring systems in determining the economic burden to maxillofacial trauma patients in India[J]. J Int Oral Health, 2015, 7(4): 38-43.
[21] O'Meara C, Witherspoon R, Hapangama N, et al. Alcohol and interpersonal violence may increase the severity of facial fracture[J]. Br J Oral Maxillofac Surg, 2012, 50(1): 36-40.
[22] Bertram A, Hyam D, Hapangama N.Out-of-hours maxillofacial trauma surgery: a risk factor for complications?[J]. Int J Oral Maxillofac Surg, 2013, 42(2): 214-217.
[23] Velayutham L, Sivanandarajasingam A, O'Meara C, et al. Elderly patients with maxillofacial trauma: the effect of an ageing population on a maxillofacial unit's workload[J]. Br J Oral Maxillofac Surg, 2013, 51(2): 128-132.
[24] Aladelusi T, Akinmoladun V, Olusanya A, et al.Analysis of road traffic crashes-related maxillofacial injuries severity and concomitant injuries in 201 patients seen at the UCH, Ibadan[J]. Craniomaxillofac Trauma Reconstr, 2014, 7(4): 284-289.
[25] Shetty V, Atchison K, Der-Matirosian C, et al.The mandible injury severity score: development and validity[J]. J Oral Maxillofac Surg, 2007, 65(4): 663-670.
[26] 陈晨,张益,安金刚,等.3种颌面部创伤评分评估下颌骨骨折的比较研究[J].实用口腔医学杂志,2015,31(1): 68-72.

4种创伤评分评估颌面部骨折效果比较

Comparative study of four trauma scoring systems to evaluate maxillofacial fractures

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