颅脑外伤手术前后CT影像分析

CT Imaging Analysis of Craniocerebral Trauma Pre and Post Operation

对比颅脑外本文收集颅脑外手术患者106例，大部份在伤后1小时至数小时内作CT扫描目的是提高对颅脑外伤手术前后CT表现变化的认识，使病人得到及时有效治疗。材料和方法：收集颅脑外伤手术患者106例，伤后1小时至13天作CT检查，大部分在外伤后数小时内CT检查，全部病例在手术后10天内CT复查1次以上。均采用颅骨钻孔引流或去骨瓣减压术。将手术前后CT表现进行对比影像分析。结果：单纯硬膜外血肿，术后出现脑挫裂伤较少，且程度较径：硬膜外血肿伴脑挫裂伤，术后短期内脑挫伤会不变或加重，但大多数病灶会缩小。单纯硬膜下血肿，术后发生脑挫裂伤和／或硬膜外血肿的比率较高，达51.72％：硬膜下血肿伴脑挫裂伤手术后其挫裂伤程度加重者占38．46％：硬膜下血肿伴或不伴脑挫裂伤再次手术率为21．43％。外伤后脑梗塞17例，发生于术前仅1例，术后6例，可能与手术有关结论：颅脑外伤手术后作CT检查可发现其术后变化情况，并能指导临床及时有效地再次手术治疗。

Objective: To improve the ability of recognizing CT changes changes of cranioerebral trauma pre and post operation, for the sake of treating patients immediately and effectively.Materials and Methods:106 operated cases for craniocerebral trauma were collected, which were performed CT scanning from 1 hour to 13 days, mostly several hours after trauma. One or more follow-up CT scan were taken in all cases within ten days after operation, Sphenotresia or craniotomy with bone flap was performed in all cases. CT findings of the pre and post operation were analysed contrastively. Results : Simple epidural haematoma cases had a little and slight contusion and laceration of the brain after operation. In the cases of epidural haematoma with contusion and laceration of the brain, their contusion and laceration might be constant or became more serious in a short bine, but these lesions might reduce afterwards. In simple subdural haematoma cases, the frequency of contusion and laceration of the brain and/or epidural haematoma was high up 51.72% post-operatively. In the cases of subdural haematoma with contusion and laceration, their contusion and laceration became more serious in 38.46 %. In subdural haematoma with or without contusion and laceration cases, their re-operation rate was 21.43 %. Among the 17 post-tfaumatic cerebral infarction cases, l occurred before operation, the others after operation.Conclusion: In craniocerebral trauma CT scan after operation is able to discover post-operative changes and direct clinical re-operation immediately and effectively.