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[意识病理障碍的量化。可靠性标准、目标、可行性]

[Quantifying pathological disorders of consciousness. Reliability criteria, aims, feasibility].

作者信息

Spittler J F, Langenstein H, Calabrese P

机构信息

Neurologische Klinik, Ruhr-Universität Bochum.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 1993 Jun;28(4):213-21. doi: 10.1055/s-2007-998910.

Abstract

Within a survey of coma scales we distinguish scales of clinical findings (Glasgow Coma Scale [GCS], Glasgow Liège Scale [GLS], Innsbruck Coma Scale [ICS], Comprehensive Level of Consciousness Scale [CLOCS]), grading tests (Vigilance Scale [VS], Funktionspsychose-Skala-B [FPBS-B]) and level-scales (Reaction-Level-Scale [RLS-85], Munich Coma Scale [MCS]). With regard to the purpose we differentiate a classification of depth, the prediction of prognosis and the monitoring of changes. For the purpose of classification of depth, the RLS-85 because of its superior objectivity is preferable, but the GCS is of comparable validity and more widely used. The GLS differentiates the deeper states of coma better than either of these because brainstem-reflexes in cranio-caudal order are added. Within the prediction of prognosis all coma-scales have only limited validity and for the purpose of resource economy require additional criteria in the individual case. For the purpose of monitoring changes the level-scales primarily do not fit, the GCS is not sensitive enough. The Glasgow-Cologne-List is better suited; it is more than one-dimensional, but can be expressed through the GCS numbers for comparative purposes. The ICS is not widely used and the prognostic validity has not been proven to the same extent. The Glasgow-Cologne-List could be amplified for the less severe disturbances of consciousness according to Price (32,33), and for the lower levels according to the GLS (2,3,4). In both cases the expense is slightly higher.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在昏迷量表调查中,我们区分了临床检查量表(格拉斯哥昏迷量表[GCS]、格拉斯哥列日量表[GLS]、因斯布鲁克昏迷量表[ICS]、综合意识水平量表[CLOCS])、分级测试量表(警觉量表[VS]、功能性精神病量表-B[FPBS-B])和水平量表(反应水平量表[RLS-85]、慕尼黑昏迷量表[MCS])。就目的而言,我们区分了深度分类、预后预测和变化监测。为了进行深度分类,RLS-85因其更高的客观性更可取,但GCS具有相当的有效性且应用更广泛。GLS比这两者都能更好地区分更深层次的昏迷状态,因为它增加了按头-尾顺序排列的脑干反射。在预后预测方面,所有昏迷量表的有效性都有限,出于资源节约的目的,个别病例需要额外的标准。为了监测变化,水平量表基本不适用,GCS不够敏感。格拉斯哥-科隆清单更合适;它不止一维,但为了比较目的可以用GCS数字表示。ICS应用不广泛,其预后有效性也未得到同等程度的证实。根据普赖斯(32,33)的方法,格拉斯哥-科隆清单可以针对较轻的意识障碍进行扩充,根据GLS(2,3,4)针对较低水平进行扩充。在这两种情况下,成本都略高。(摘要截断于250字)

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