弥漫性轴索损伤患者颅脑CT表现与格拉斯哥昏迷评分法评分及临床预后的关系分析  

Analysis of CT manifestations of brain in patients with diffuse axonal injury and its relationship with Glasgow coma scale score and clinical prognosis

作　　者：李铁 LI Tie(Department of CT,the First Hospital of Dandong,Dandong,Liaoning,118000,China)

机构地区：[1]丹东市第一医院CT科,辽宁丹东118000

出　　处：《当代医学》2022年第27期165-168,共4页Contemporary Medicine

摘　　要：目的分析弥漫性轴索损伤(DAI)患者颅脑CT表现与格拉斯哥昏迷评分法(GCS)评分、临床预后的关系。方法回顾性分析2018年6月至2020年6月本院收治的100例经手术病理检查确诊为DAI患者的临床资料,分析颅脑CT表现,根据CT表现将患者分为累及脑中线组(n=44)与未累及脑中线组(n=56),比较两组GCS评分及临床预后。结果100例DAI患者颅脑CT表现:脑组织有不同程度肿胀,灰质与白质界限模糊不清;其中出现双侧侧脑室变小及对称性受压68例,脑室消失9例,单侧侧脑室受压变小2例,三脑室横径变小8例,环池、鞍上池受压变小47例,闭塞消失23例;脑组织出现散在的蜘蛛网状模糊影、小斑片状出血、点状出血89例,出血部位:胼胝体14例,基底节区12例,脑干9例,小脑5例,大脑半球皮髓质交界处49例;脑中线轻度移位(累及脑中线)44例,移位距离0.4~1.5 cm,脑中线未见明显移位(未累及脑中线)56例。累及脑中线组死亡及植物人占比明显高于未累及脑中线组,差异有统计学意义(P<0.05)。累及脑中线组GCS评分为(5.69±2.67)分,明显低于未累及脑中线组的(10.14±3.18)分,差异有统计学意义(P<0.05)。结论DAI累及脑中线患者预后更差,GCS评分更低,CT技术可有效诊断DAI,评估患者预后情况,可指导临床医师制订治疗方案。Objective To analyze the CT manifestations of brain in patients with diffuse axonal injury(DAI)and its relationship with Glasgow coma scale(GCS)score and clinical prognosis.Methods The clinical data of 100 patients with DAI diagnosed by surgery and pathology in our hospital from June 2018 to June 2020 were retrospectively analyzed,the CT manifestations of the brain were analyzed,and they were divided into the midline involved group(n=44)and the non-midline involved group(n=56)according to the CT manifestations,the GCS score and clinical prognosis were compared between the two groups.Results The CT manifestations of brain of 100 patients with DAI showed that the brain tissue swelled to varying degrees,and the boundary between gray matter and white matter was unclear in 100 patients;68 cases had bilateral ventricles smaller and symmetrical compression,9 cases of ventricular disappeared,2 cases of unilateral ventricular compression,8 cases of the transverse diameter of the third ventricle decreased;47 cases of cisterna annularis and suprasellar cisterna became smaller;23 cases of occlusion disappeared.There were 89 cases of scattered spider like blurry shadow,small patchy hemorrhage and punctate hemorrhage occurred in brain tissue,the bleeding sites included corpus callosum in 14 cases,basal ganglia in 12 cases,brain stem in 9 cases,cerebellum in 5 cases,and cortex medullary junction of cerebral hemisphere in 49 cases.There were 44 cases with mild midline displacement(midline involved),the displacement distance was 0.4-1.5 cm,and 56 cases without significant midline displacement(non-midline involved).The proportion of death and vegetative state in the midline involved group was significantly higher than that in the non-midline involved group,and the difference was statistically significant(P<0.05).The GCS score of the midline involved group was(5.69±2.67)scores,which was significantly lower than(10.14±3.18)scores of the non-midline involved group,and the difference was statistically significant(P<0.05).Conclusion

关 键 词：弥漫性轴索损伤 电子计算机断层扫描 格拉斯哥昏迷评分法 

分 类 号：R651.15[医药卫生—外科学] R816.1[医药卫生—临床医学]