颅脑创伤严重程度与结局评分的方法--格拉斯哥评分

摘要

长期以来严重颅脑创伤伤情程度与结局的评估都是困难和棘手的问题。自从1974年Teasdale和Jennett建立了通过病人眼运动反应、言语反应和运动反应来评估病人的意识水平的方法后，格拉斯哥昏迷评分(Glasgow Coma Scale，GCS)凭借其简单、易于掌握和使用、能较准确地描述了病人昏迷和意识程度等特点，得到广泛的应用和推广，被用于临床颅脑损伤的伤情评估、临床分型、以及颅脑伤的预后判断之中。在随后的几十年中产生了系列改良的格拉斯哥评分方法：格拉斯哥-列日评分( Glasgow-Liege Scale，GLS)、格拉斯哥匹兹堡昏迷评分(Glasgow Pittsburgh Coma Scale, GCSP)、Adelaide儿科昏迷评分(Adelaide Pediatric Coma Scale)、格拉斯哥结局评分(Glasgow Outcome Scale，GOS)和扩展格拉斯哥结局评分(Extended Glasgow Outcome Scale，EGOS)等，使其得到不断完善和发展。GCS已成为世界颅脑损伤严重程度和病情变化监测的可靠的工具和通用语言。本文对格拉斯哥评分的历史、方法、适用条件、特点与不足等进行详细的综述。%It's a difficult problem to assess the severity and outcome for serious craniocerebral trauma for a long time. After 1974 Teasdale and Jennett put forward the method to assess the patient's consciousness by patient's eye opening, verbal and motor response, Glasgow Coma Scale (GCS) with its simple, easy to master and use, accuracy on the description of consciousness and coma was wildly used in the severity assessment, clinical classification, and trend assessment of head injury. In the following decades, a series of modified Glasgow Scales were produced and developing:Glasgow-Liege Scale (GLS), Glasgow Pittsburgh Coma Scale(GCSP), Adelaide Pediatric Coma Scale(APCS), Glasgow Outcome Scale(GOS) and Extended Glasgow Outcome Scale(EGOS), etc. GCS has been a reliable tool and a universal language for monitoring craniocerebral injury severity and condition change all around the world. The history, methodology, optimum conditions, characteristics and deficiency of Glasgow scales were reviewed in detail in this paper.