外伤性蛛网膜下腔出血对重型颅脑损伤患者Marshall CT分级预后的影响  

An evaluation of the prognostic value of traumatic subarachnoid hemorrhage to Marshall's computerized tomography classification in patients with severe traumatic brain injury

作　　者：杨小锋[1] 温良[1] 王芳[1] 王浩[1] 龚江标[1] 李谷[1] 

机构地区：[1]浙江大学医学院附属第一医院,杭州310003

出　　处：《浙江创伤外科》2011年第5期577-579,共3页Zhejiang Journal of Traumatic Surgery

基　　金：浙江省科技厅资助项目(2007C33011)

摘　　要：目的研究外伤性蛛网膜下腔出血是否影响颅脑损伤患者MarshallCT分级的预后。方法收集本院2008年2月至2008年12月间共66例重型颅脑损伤患者,按照MarshallCT分级分为弥漫性损伤组和局灶性损伤组,分析外伤性蛛网膜下腔出血的发生率及对其预后的影响。结果 66例重型颅脑损伤的患者中,合并外伤性蛛网膜下腔出血的发生率高达77.27%,并且预后较差。根据MarshallCT分级,弥漫性损伤组中,伤后6个月GOS评分合并蛛网膜下腔出血者平均为3.00,不合并者为4.25;局灶性损伤组中,伤后6个月GOS评分合并蛛网膜下腔出血者平均为1.91,不合并者为3.00,两者有统计学差异(P<0.05)。结论外伤性蛛网膜下腔出血在重型颅脑损伤患者中极为常见,并且影响MarshallCT分级的预后。Objective Study on the prognostic value of traumatic subarachnoid hemorrhage to Marshall＇s CT classification in patients with severe traumatic brain injury. Methods We performed an analysis of cases with severe tiaumatic brain injury in inpatients between February 2008 and December 2008, the incidence of tSAH and its relationship with outcome as well as the prognositic influence with tSAH to Marshall＇s CT classification of diffused injury group and localized injury group. Results In all 66 patients with severe traumatic brain injury, the incidence of tSAH is 77.27% and the outcome of patients with tSAH is significantly worse than those without tSAH. According to Marshall＇s CT classification of diffused injury group, the average score of GOS at 6 months after trauma with tSAH was 3.00, without tSAH it was 4.25. In localized injury group, the average score of GOS at 6 months after trauma with tSAH was 1.91, without tSAH it was 3.00. There was statistical difference between them（P〈0.05）. Conclusion Traumatic subarachnoid hemorrhage is very common in patients with severe traumatic brain injury and it is an independent outcome predictor of CT characteristic according to Marshall＇s CT classification.

关 键 词：外伤性蛛网膜下腔出血 重型颅脑损伤 Marshall CT分级 预后 

分 类 号：R651.15[医药卫生—外科学]