颅脑损伤后CT估价颅内压的方法及意义  

Method and Significance of Estimating the Intracranial pressure by CT Scan in Closed Head Trauma

作　　者：赵欣春[1] 张平[1] 肖绪林[1] 

机构地区：[1]天津市脑系科医院神经放射科

出　　处：《实用放射学杂志》1998年第8期453-455,共3页Journal of Practical Radiology

摘　　要：目的：探讨应用ＣＴ对闭合性颅脑损伤病人进行颅内压（ＩＣＰ）估价。方法：对１００例颅脑损伤后患者行ＣＴ扫描，分析其ＣＴ变化特征，对ＩＣＰ进行估价，并与ＩＣＰ监护值对照。ＣＴ变化特征估价内容：脑室、脑池大小形态，中线结构移位，颅内占位性损伤病灶大小。结果：下列ＣＴ改变可估价ＩＣＰ：（１）实质内血肿破入脑室，继发性梗阻性脑积水ＩＣＰ显著升高；（２）三脑室、基底池受压或消失ＩＣＰ明显升高；（３）侧脑室受压ＩＣＰ可升高；（４）中线结构移位大于５ｍｍ时ＩＣＰ升高；（５）占位性损伤灶体积小于２０ｍｌ时与ＩＣＰ升高程度无明显关系，体积大于２０ｍｌ时与ＩＣＰ升高程度相关。结论：通过ＣＴ变化，能够估价颅内压，并以此指导治疗，判断愈后。Purpose:To explored how to estimate the intracranial pressure(ICP) in closed head trauma by CT.Method:100 cases with closed head trauma were imaged by CT.The CT findings and ICP were analysed and compared with the super vising data of ICP.The CT findings which was used to estimate ICP were as follows:The size and shape of the ventricle & cerebral cistern,midline shift,and the size of intracranial traumatic occupyied lesions.Results:The following CT changes could result in rise of ICP:1.The parenchymal hematoma broken in to ventricle ;2.Either compression or obliteration of the third ventricle and the basic cistern;3.compression of lateral ventride;4.The midline shift more than 5 mm;5.Traumatic occupied lesions more than 20 ml.Conclusion:Intracranial pressure can be estimated by CT changes.It is can be used to guide treatment and to judge prognosis of patients with closed head trauma.

关 键 词：颅脑损伤 诊断 CT 颅内压 

分 类 号：R651.150.4[医药卫生—外科学] R816.1[医药卫生—临床医学]