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目的根据小样本严重意识障碍患者纵向研究,对常用临床意识量表进行评估。方法选取在武警杭州医院脑康复中心2005年6月至2006年2月间进行了唤名刺激脑功能成像(fMRI)检测的11名严重意识障碍患者进行前瞻性研究。用常用意识量表对11例严重意识障碍患者进行评分,并在fMRI检测后3个月用改进的昏迷康复量表(CRS-R量表)进行每月一次跟踪检测。以CRS-R量表的纵向评分分值结合fMRI研究结果作为患者分组依据,对各意识量表的总分和子项目分值进行One-Way ANOVA组间差异性分析。结果在所有项目中,除了CRS-R量表中的交流子量表(P=0.019),其他项目的组间差异无统计学意义;在受评意识量表中,Wessex脑损伤模块(WHIM)在总体上的组间差异无统计学意义(P=0.066),中国植物状态评估量表(CVSS)的组间差异无统计学意义(P=0.866)。结论用客观方法对常用意识量表及子项目的评估结果表明各量表及子项目的诊断价值总体较差,项目之间的诊断价值存在较大差异。
Objective According to the longitudinal study of patients with severe disturbance of consciousness in small sample, the common clinical awareness scale was evaluated. METHODS: A prospective study was conducted in 11 severely impaired cognition patients who underwent auricular stimulation of brain imaging (fMRI) between June 2005 and February 2006 in Hangzhou Rehabilitation Center of Armed Police Forces. Eleven patients with severe unconsciousness were scored on a common sense scale and tracked on a monthly basis with an improved coma recovery questionnaire (CRS-R scale) 3 months after the fMRI test. The longitudinal score of CRS-R scale combined with the fMRI findings were used as the basis for grouping patients. One-Way ANOVA was used to analyze the differences between the total score and sub-item scores of each scale. Results Among all the items, except for the communicator sub-scale (P = 0.019) in the CRS-R scale, there was no significant difference among the other groups. In the scale of rating scale, Wessex brain injury module (WHIM) There was no significant difference between the two groups (P = 0.066). There was no significant difference between the two groups in the plant status assessment scale (CVSS) (P = 0.866). Conclusion The assessment results of common sense scale and sub-project by objective method show that the diagnostic value of each scale and sub-project is generally poor, and the diagnostic value of the project is quite different.