CT对晚发性维生素K缺乏症所致颅内出血诊断的价值

Value of CT in diagnosing intracranial hemorrhage due to delayed vitamin K deficiency

目的评价CT对晚发性维生素K缺乏所致颅内出血患儿诊断的应用价值。方法回顾性分析经临床及CT确诊的173例晚发性维生素K缺乏所致颅内出血患儿的临床CT表现。结果2个或2个以上部位出血共124例(71.68%),常为硬膜下、蛛网膜下腔、脑实质多部位混合性出血,可伴有缺氧缺血性脑病及大片脑梗塞。硬膜下、蛛网膜下腔出血吸收较完全;出血量多,脑内血肿较大,特别是伴大片脑梗塞者常有脑软化灶后遗改变。结论CT检查可早期确定颅内出血部位及范围,了解是否伴有缺氧缺血性脑病、脑梗塞、脑疝等并发症,并且对指导临床制定治疗方案、观察疗效、了解病情发展和判断预后等方面起着重要作用,可作为本病的首选检查方法。

Objective To evaluate CT in diagnosing intracranial hemorrhage due to delayed vitamin K deficiency （DVKD）. Methods Intracranial hemorrhage features were retrospectively analyzed in 173 cases of DVKD determined by clinical features and imaging. Results Intracranial hemorrhage of 124 cases （71.68%） involved two or more anatomical areas, which were often subdural cavity, subarachnoidal cavity, and brain parenchyma, and may be accompanied with hypoxic-ischemic encephalopathy and cerebral infarct. Subdural and subarachnoidal hemorrhage resolved more completely than cerebral blood mass. Massive volume hemorrhage in any anatomical area, especially when coupled with large patch of brain infarct, readily led to cerebral malacia. Conclusion It is valid to take CT as the optimal checkup in evaluating the brain injury caused by DVKD for the advantages ： early determination of the location and extent of intracranial hemorrhage, disclosing the complications （hypoxic-ischemic encephalopathy, cerebral infarct, and brain hernia） so as to guide treatment plan alteration, observe treatment reaction and disease development and judge prognoses.