目的：探讨以休克指数作参数的修正创伤评分（RTS）用于地震现场躯干伤伤员转运前伤情评估时的应用价值。方法回顾性分析汶川地震伤情数据库中资料齐全的1322例汶川地震躯干伤伤员数据，其中男553例、女769例，年龄（59.7±21.7）岁。计算伤员的RTS包括创伤分类修正创伤评分（Triage-RTS）和严重创伤转归研究修正创伤评分（MTOS-RTS），并改用休克指数替代收缩压来进行RTS中的循环评估，从而建立转运前修正创伤评分（Transport-RTS）的概念。通过ROC曲线分别比较Transport-RTS与Triage-RTS、MTOS-RTS评价转运中以及急诊室死亡中的作用，分别计算灵敏度、特异度等指标。结果Transport-RTS、Triage-RTS和MTOS-RTS用于地震现场伤员转运前伤情评估时的ROC曲线下面积分别为0.768,0.563,0.563；Transport-RTS的ROC曲线下面积显著大于Triage-RTS和MTOS-RTS，均P<0.05。结论Transport-RTS用于地震现场伤员转运前伤情评估时准确度更高，同时保持了简易、快速的特点。%Objective To study the value of shock index (SI) as reference for assessing those wounded caused by earthquake disaster prior to be transported. Methods A retrospective analysis was conducted on a total of 1,322 wounded (553 males and 769 females) with torso trauma in Wenchuan earthquake, with ages of 59.7 ± 21.7 years old. The values of the revised trauma scores (RTS), including triage-RTS and major trauma outcome study (MOTS)-RTS, were calculated. SI was used instead of SBP in the assessment of circulation in RTC to establish the concept of RTC prior to the transportation (Transport-RTC). The mortality in the transportation to hospital, arrival at the hospital, and during in intensive care unit (ICU) was respectively drawn in a receiver/operator curve (ROC). The areas under the ROC were calculated. Results The area under ROC of Transport-RTS was 0.768, significantly bigger than those of the triage-RTS and MTOS-RTS, 0.563 and 0.563 respectively, both P <0.05.Conclusion Transport-RTS is considered being more specific and effective in assessing the condition of torso trauma caused by earthquake prior to the patients being transported. Simultaneously, it carries out the advantages of simplicity and rapidness.
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