弥漫性轴索损伤患者颅脑CT表现及与GCS评分、临床预后的关系分析  

CT Findings of Patients with Diffuse Axonal Injury and Its Relationship with GCS Score and Clinical Prognosis

作　　者：林芸 尚娟 曹海泉 LIN Yun;SHANG Juan;CAO Hai-quan(Department of ICU of Jialing Hospital,Nanchong Central Hospital,Nanchong 637000,Sichuan Province,China)

机构地区：[1]南充市中心医院嘉陵院区ICU,四川南充637000

出　　处：《中国CT和MRI杂志》2020年第9期31-33,共3页Chinese Journal of CT and MRI

基　　金：四川省卫计委科技项目(18PJ273)。

摘　　要：目的分析弥漫性轴索损伤患者颅脑CT表现及与GCS评分、临床预后的关系。方法选取2018年1月至2019年4月南充市中心医院神经外科收治的90例弥漫性轴索损伤患者,收集患者临床及影像学资料。观察记录患者CT的表现,观察病灶是否累及脑中线部位,并将其分为累及组和不累及组;记录患者的临床预后情况及GCS计分。结果 CT检查下显示90例弥漫性轴索损伤患者,其中42例患者病灶累及脑中线部位,48例患者病灶未累及脑中线部位。病灶累及脑中线部位组与病灶未累及脑中线部位组的临床预后比较差异有统计学意义(P<0.05),病灶未累及脑中线部位组患者的临床预后显著优于病灶累及脑中线组的患者;病灶累及脑中线部位组与病灶累及脑中线部位组的GCS计分比较差异有统计学意义(P<0.05),病灶累及脑中线部位组患者的GCS计分情况比病灶未累及脑中线组严重,计分更低。结论颅脑CT检查是临床上诊断弥漫性轴索损伤的重要方法,可为临床上早期诊断和治疗提供丰富的信息。其次DAI的病灶累及脑中线部位的患者其临床预后差并且GCS计分较低,可为临床提供重要参考价值。Objective To analyze the CT findings of patients with diffuse axonal injury and its relationship with GCS score and clinical prognosis.Methods 90 patients with diffuse axonal injury admitted to neurosurgery department of our hospital from January 2018 to April 2019 were enrolled.Clinical and imaging data were collected.Observe and record the patient’s CT performance,observe whether the lesion involves the midline of the brain to divide patients into the involved group and the non-involved group.The patient’s clinical prognosis and GCS scores were recorded.Results CT examination showed that in 90 patients with diffuse axonal injury,there were 42 patients whose lesions involved the midline of the brain,and 48 patients whose lesions did not involve the midline of the brain.There was a statistically significant difference in the clinical prognosis between the involved group and the non-involved group (P<0.05).The clinical prognosis of patients in the non-involved group was significantly better than that of patients in the involved group.There was a statistically significant difference in the GCS scores between the involved group and the non-involved group (P<0.05).The condition in GCS scores of the patients in the involved group was more serious than that of the patients in the non-involved group,and the scores of the patients in the involved group were lower than those of the patients in the non-involved group.Conclusion Cerebral CT examination is an important method for clinical diagnosis of diffuse axonal injury,which can provide rich information for early clinical diagnosis and treatment.Secondly,patients whose DAI lesions involved the midline of the brain have poor clinical prognosis and low GCS scores,which can provide important reference value for the clinical treatment.

关 键 词：弥漫性轴索损伤 颅脑CT GCS评分 临床预后 

分 类 号：R445.3[医药卫生—影像医学与核医学] R642[医药卫生—诊断学]