血性脑脊液与颅脑CT异常的相关性研究

Correlation between bloody cerebrospinal fluid and craniocerebral CT abnormality

目的研究脑外伤后血性脑脊液检出率与颅脑CT异常的关系。方法对49例典型脑震荡病人行腰椎穿刺,检查其血性脑脊液的发生率。对42例蛛网膜下腔出血病人行颅脑CT复查,当颅脑CT正常时行腰椎穿刺及脑脊液检查。结果在49例典型脑震荡病人中,血性脑脊液检出率为18.4%(n=9)。在42例蛛网膜下腔出血病人中,当颅脑CT显示出血吸收时,血性脑脊液检出率为90.5%(n=38)。红细胞计数平均为14.1×106/L。结论对少量蛛网膜下腔出血病人,颅脑CT检查存在一定漏诊率,只有脑脊液中红细胞计数达到一定数值,才能出现颅脑CT异常。

Objective To investigate the correlation bewteen bloody cerebrospinal fluid and craniocerebral CT abnormality after brain trauma. Methods The incidence of bloody cerebrospinal fluid in 49 patients with typical brain concussion was examined by lumbar puncture. The craniocerebral CT reexaminations in 42 patients with subarachnoid hemorrhage（SAH）were performed when craniocerebral CT was normal, simultaneously, the incidence of bloody cerebrospinal fluid was examined by lumbar puncture. Results Among 49 patients with typical brain concussion, the incidence of bloody cerebrospinal fluid was 18.4% （ n = 9）. Among 42 patients with subarachnoid hemorrhage, when craniocerebral CT revealed the hemorrhage, when craniocerebral CT revealed the hemorrhage to be absorbed the incidence of bloody cerebrospinal fluid was 90.5% （ n =38）and the mean count of red blood cell（RBC）in ccrebrospinal fluid reached 14. 1× 10^6/L. Conclusion In the patients with little subarachnoid hemorrhage, craniocerebral CT examinations have probably certain leak - diagnositic rate, and therefore only when the count of RBC in cerebrospinal fluid reach to certain value the craniocerebral CT abnormalities can be found.