Lancet:儿童颅脑损伤判定规则

2017-04-12 MedSci MedSci原创

PECARN CATCH CHALICE三种临床测试对儿童颅脑损伤的准确性较高,有希望进行临床推广帮助医生做出下一步决策

临床测试有助于临床医师确定颅脑损伤儿童患者治疗方向。研究者在一个临床儿童大样本中验证三个临床测试的准确性(PECARN、 CATCH和CHALICE)。

研究对象为澳大利亚和新西兰医院急诊室中,18岁以下、头部严重受伤的儿童和青少年,以评估三个临床测试的准确性。

试验样本共包含20137名少年儿童。在5374名2岁以下儿童中,有4011名(75%)采用了PECARN测试,14763名2岁以上儿童中有11152名(76%)采用PECARN测试;CATCH测试在4957名患儿中使用(25%)而CHALICE测试对20029名患儿使用(99%)。在2岁以下患儿的测试验证的准确性最高为100%(95% CI 90.7-100),在2岁以上患儿测试验证的准确性为99%(95% CI 94.4-100);CATCH高风险的预测准确性为95.2%,中等风险和低风险预测为88.7%;CHALICE验证的准确性为92.3%。对于18913名中度损伤患儿,三种测试的准确性与现行的外伤性脑损伤测试(TBI)相一致。

三种临床测试对儿童颅脑损伤的准确性较高,有希望进行临床推广帮助医生做出下一步决策。

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