外伤性颅脑损伤患者CT征象及预后的临床分析  

Clinical analysis of CT signs and prognosis in patients with traumatic brain injury

作　　者：叶明晖 何建斌[2] 许志鹏 YE Minghui;HE Jianbin;XU Zhipeng(Department of Radiology, Hangzhou Ninth People's Hospital, Hangzhou 311225, P.R.China;Department of Radiology, Jinhua People's Hospital, Jinhua 321000, P.R.China)

机构地区：[1]浙江省杭州市第九人民医院放射科,浙江杭州311225 [2]浙江省金华市人民医院放射科,浙江金华321000

出　　处：《医学影像学杂志》2022年第1期11-15,共5页Journal of Medical Imaging

基　　金：浙江省温岭市科技计划社会项目(编号:2016C31BA0027)。

摘　　要：目的探讨CT征象、脑脊液/脑内室体积(CSF/ICV)对外伤性颅脑损伤患者病情的评估价值。方法选取我院202例外伤性颅脑损伤患者资料,根据病情程度分为轻度组(53例)、中度组(72例)、重度组(48例)、特重度组(29例)。比较4组CT征象、CSF/ICV,分析两者与病情程度的相关性,评价其对重度及以上外伤性颅脑损伤的评估价值,并随访30天,对比不同CT征象、CSF/ICV患者预后情况,分析两者与预后的关系。结果4组基底池、中线移位、血肿、蛛网膜下腔出血、Rotterdam CT评分、CSF/ICV差异有统计学意义(P<0.05);Rotterdam CT评分、CSF/ICV与病情程度呈正相关(r=0.715、0.672,P均<0.001);Rotterdam CT评分、CSF/ICV联合评估重度及以上外伤性颅脑损伤的AUC为0.877,大于两者单独评估,95%CI为0.824~0.919,敏感度为87.01%,特异度为78.40%;随访30天,Rotterdam CT评分、CSF/ICV高水平患者预后不良发生率高于低水平患者(P<0.05);Rotterdam CT评分、CSF/ICV与外伤性颅脑损伤患者预后不良独立相关(P<0.05)。结论CT征象、CSF/ICV对外伤性颅脑损伤患者病情程度具有可靠评估价值,且与预后独立相关,对临床有指导意义。Objective To explore the evaluation value of CT signs and cerebrospinal fluid/intraventricular volume(CSF/ICV)in patients with traumatic head injury and their relationship with prognosis.Methods A total of 202 patients with traumatic brain injury in our hospital were selected as the research objects,and they were divided into mild group(53 cases),moderate group(72 cases),severe group(48 cases),and very severe group(29 cases)according to their severity.We compared the 4 groups of CT signs,CSF/ICV,analyzed the correlation between the two and the severity of the disease,evaluated their evaluation value for severe and above traumatic head injury,and followed up for 30 days to compare the prognosis of patients with different CT signs and CSF/ICV Situation,analyzed the relationship between the two and the prognosis.Results Differences in basal cistern,midline displacement,hematoma,subarachnoid hemorrhage.Rotterdam CT score and CSF/ICV were statistically significant(P<0.05);Rotterdam CT score and CSF/ICV were positively correlated with the severity of the disease(r=0.715,0.672,P<0.001);Rotterdam CT score and CSF/ICV combined assessment of severe and above traumatic brain injury AUC was 0.877,greater than the two assessment alone,95%CI was 0.824~0.919,sensitivity was 87.01%,the specificity was 78.40%.As follow-up for 30 days,the incidence of poor prognosis in patients with high levels of Rotterdam CT score and CSF/ICV was higher than that of patients with low levels(P<0.05);Rotterdam CT score,CSF/ICV,or traumatic brain injury with the poor prognosis of patients was independently correlated(P<0.05).Conclusion CT signs and CSF/ICV have a reliable evaluation value for the condition of patients with traumatic brain injury,and are independently related to the prognosis,which have good guiding significance for clinical diagnosis and treatment.

关 键 词：外伤性颅脑损伤 体层摄影术 X线计算机 脑脊液 脑内室体积 

分 类 号：R742[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]