急性颅脑创伤CT表现与临床分级的相关性

Acute Craniocerebral Trauma: Correlation of CT Appearances and Clinical Grades

目的：探讨急性颅脑创伤CT表现与临床分级的关系。材料与方法；收集184例急性颅脑创伤病例，根据Glasgow昏迷分级作临床分级评定，进行头颅CT扫描，就其CT表现与临床分级进行相关性分析。结果：部分轻、中度颅脑创伤CT未见异常；局灶性与弥散性颅脑损伤的临床分级差异较为明显（P＜0．05），且局灶性损伤的临床分级因颅内出血量及脑中线结构移位程度不同而不同；单纯性与复合性颅脑损伤的临床分级差异显著（P＜0．01），但单纯性损伤的病变分型与临床分级无关联，复合性损伤是否合并颅骨骨折与临床分级无关联。结论：颅脑损伤病变的类型、分布方式、颅内出血量及脑中线结构移位程度与其神经功能损伤程度有关。

To determine whether CT appearances of acute craniocerebral trauma correlated with clinical grades. Materials and Methods: 184 patients with acute craniocerelral trauma underwent CT Scanning and their clinical grades were assessed with Glasgow Coma Scale (GCS). The correlation between CT appearances of acute craniocerebral trauma and their clinical grades was studied. Results: CT appearances would be normal in some patients with mild and moderate injury. There was a significant difference of clinical grades between focal injuries and diffuse injuries (P＜0.05). In patients with focal craniocerebral injury, their clinical grade correlated both with the volumes of intracranial hemorrhage and with distances of midline shift. There was a significant difference of clinical grades between simple injuries and complex injuties (P＜0.01). To patients with simple craniocerebral injuries, their clinical grades did not correlate with the types of lesions. To patients with complex craniocerebral in-juries, their clinical grades did not correlate with skull fractures. Conclusion: The severity of neurologic dysfunction of patients with acute craniocerebral trauma related to the types of injury、the patterns of intracranial lesion distribution、the sises of intracra-nial hemorrhage、and the distances of cerebral midline shift.