多层螺旋CT征象及相关参数与严重创伤患者发生低血容量性休克的相关性  

Correlation of multi-slice spiral CT signs and relevant parameters with hypovolemic shock in patients with severe trauma

作　　者：林毅 刘刚 陈水斌 LIN Yi;LIU Gang;CHEN Shuibin(Department of Radiology,No.909 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Southeast Hospital Affiliated to Xiamen University,Zhangzhou 363000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇九医院,厦门大学附属东南医院放射诊断科,福建漳州363000

出　　处：《医学影像学杂志》2024年第3期82-85,93,共5页Journal of Medical Imaging

基　　金：福建省漳州市科技拥军项目(编号:ZZ2022KD03)。

摘　　要：目的探究多层螺旋CT(MSCT)征象及相关参数与严重创伤患者发生低血容量性休克的相关性。方法纳入我院收入的严重创伤患者86例,均行CT增强检查,并按照CT检查后是否发生低血容量性休克分为休克组(44例)、未休克组(42例),比较两组患者影像学征象及主动脉、肠系膜上静脉、肠系膜上动脉、下腔静脉各平面直径及CT值,进行低血容量性休克的Logistics回归分析。结果休克组下腔周围光环征患者占比显著高于未休克组(P<0.05),其余影像学征象比较差异无统计学意义(P>0.05);休克组肠系膜上动脉及静脉、下腔静脉4个平面(IVC1、IVC2、IVC3、IVC4)直径均显著小于未休克组,差异有统计学意义(P<0.05);休克组增强早期肠系膜上动脉CT值显著低于未休克组,下腔静脉IVC1平面CT值显著高于未休克组,差异有统计学意义(P<0.05);下腔静脉周围光环征、肠系膜上动脉直径、肠系膜上静脉直径、下腔静脉4个平面(IVC1、IVC2、IVC3、IVC4)直径、增强早期肠系膜上动脉CT值、下腔静脉IVC1平面CT值均为创伤患者发生低血容量性休克的危险因素(均OR>1,P<0.05)。结论MSCT部分征象及参数与严重创伤患者发生低血容量性休克具有相关性,可通过MSCT检查对此类患者发生低血容量性休克进行早期风险评估。Objective To explore the correlation between multi-slice spiral CT(MSCT)signs and relevant parameters and hypovolemic shock in patients with severe trauma.Methods Eighty-six patients with severe trauma admitted to our hospital were given enhanced CT examination,and were divided into shock group(44 cases)and non-shock group(42 cases)according to whether hypovolemic shock occurred after CT examination.The imaging signs,diameters and CT values of aorta,superior mes‐enteric vein,superior mesenteric artery and inferior vena cava in the two groups were compared,and the logistic regression analysis of hypovolemic shock was performed.Results The proportion of patients with peripheral halo sign in the shock group was significantly higher than that in the non-shock group(P<0.05);The diameters of superior mesenteric artery,vein and infe‐rior vena cava(IVC1,IVC2,IVC3,IVC4)in the shock group were significantly smaller than those in the non-shock group(P<0.05);The CT value of superior mesenteric artery in shock group was significantly lower than that in non-shock group,and the IVC1 plane CT value of inferior vena cava was significantly higher than that in non-shock group(P<0.05);The peripheral halo sign of the inferior vena cava,the diameter of the superior mesenteric artery,the diameter of the superior mesenteric vein,the di‐ameter of the four planes of the inferior vena cava(IVC1,IVC2,IVC3,IVC4),the CT value of the early enhanced superior mesenteric artery,and the CT value of the IVC1 plane of the inferior vena cava were all risk factors for the occurrence of hypovo‐lemic huck in the trauma patients(all OR>1,P<0.05).Conclusion Some signs and parameters of MSCT are correlated with the occurrence of hypovolemic shock in patients with severe trauma.MSCT can be used to assess the early risk of hypovolemic shock in such patients.

关 键 词：体层摄影术 X线计算机 严重创伤 低血容量性休克 下腔静脉 

分 类 号：R814.42[医药卫生—影像医学与核医学] R605[医药卫生—放射医学]