SPECT诊断重型颅脑外伤术后早期脑缺血性改变的临床意义

Diagnosis of early postoperative cerebral ischemia in severe head-injuried patients with SPECT

目的探讨头部SPECT在重型颅脑外伤术后早期脑缺血性改变的诊断意义.方法应用头部SPECT和CT分别对60例重型颅脑外伤(GCS评分3～6分,术前均发生脑疝)术后24h、72h常规检查,比较两组病人的结果.结果 24hSPECT诊断早期脑缺血性改变阳性率为90%;24hCT诊断率为42%,72h CT诊断率为92%.结果显示术后24h SPECT和CT诊断阳性率有显著差异(P<0.05).结论头部SPECT诊断重型颅脑外伤术后早期脑缺血性改变较头颅CT早期诊断有明显优越性,特别是24h内尤为显著,对早期治疗因缺血造成的继发性脑损害有重要意义.

Objective To discuss the diagnosis of early postoperative cerebral ischemia in severe head-injuried patients with SPECT, Methods 60 severe head-injuried patients （GCS 3-6, with preoperative hernia） were devided into two groups. Head SPECT and CT scanning were performed at postoperative 24h and 72h,respectively. The results were compared, Results The positive rate of early cerebral ischemia was 90% by SPECT at 24h postoperatively, but 42% by CT scanning, and 92% by CT at 72h, The positive rate by SPECT was higher than that by CT significantly （P〈0.05）, Conclusion Head SPECT is a better methed than CT scanning on the diagnosis of early cerebral ischemia in severe head-injuried patients, espescial in 24h postoperatively. SPECT could become an important diagnositic method in earlier treatment of secondary cerebral ischemia.