首次CT检查阴性的颅脑损伤54例临床分析

Clinical Analysis of 54 Traumatic Craniocerebral Injury Patients without Positive Findings on the First CT

目的分析颅脑损伤首次CT检查阴性而复查CT阳性的表现和原因。方法通过对首次CT检查阴性而复查CT阳性的54例颅脑损伤患者(研究组)的临床资料进行回顾性分析总结,并与同期收治的325例首次CT及复查CT均为阴性的颅脑损伤患者(对照组)作比较。结果研究组首次CT检查阴性而复查CT阳性表现为迟发性血肿、脑挫裂伤、脑积水、硬膜下积液、弥漫性脑肿胀、外伤性脑梗塞等,可由不同原因引起。结论熟悉本类颅脑损伤首次CT检查阴性,而复查CT阳性的表现及原因,对于指导检查及治疗,改善病人预后有重要意义。

Objective To analyse the cause of negative findings on the first CT images and to improve us in the understanding of this conditions in patients with traumatic craniocerebral injury. Methods The clinical date of 54 traumatic craniocerebral injury patients without the positive findings on the first CT images and with positive findings on the repeated CT images were analysed retrospectively, and compared to those of 325 traumatic craniocerebral injury patients, who were treated during the same period, without the positive findings on the first and repeated CT images. Results The repeated CT scans revealed delayed intracranial hemalomas, cerebral contusion, hydrocephalus, subdural effusion, diffuse cerebral swelling and traumatic cerebral infarcation induced by different cause in 54 traumatic craniocerebral injury patients without the positive findings on the first CT images. Of 54 patients, 40 recovered well, 5 were moderately disabled, 4 severely disabled, 3 survired vegetably and 2 died. Conclusion In order to improve the diagnose and curative effect, it is important to familiarize the clinical manifestation and cause of the delayed lesions in the patients with traumatic craniocerebral injury.