中重度颅脑损伤后CT影像特点、颅内压与预后的关系

Relationships among CT imaging features,intracranial pressure and prognosis after moderate or severe traumatic brain injury

目的研究中、重度颅脑损伤病人颅内压、CT影像特点及预后之间的关系。方法对28例中、重度颅脑损伤病人行颅内压监测和头部CT扫描,记录颅内压值和CT影像特点(基底池受压、中线移位、脑室受压情况),并进行Rotterdam CT评分,对这些因素进行统计学分析。结果经统计学分析:各CT影像特点与颅内压水平存在相关性,Rotterdam CT评分与颅内压水平的相关性最强。伤后24 h颅内压水平与病人预后相关性最强,而中线移位和脑室受压情况与预后无明显相关性。结论在评估中、重度颅脑损伤病人颅内压及预后方面,Rotterdam CT评分优于单个CT影像特征;颅内压与病人预后存在负相关,对中重、度颅脑损伤行颅内压监测,并进行相关治疗有利于改善预后。

Objective To research the relationships among CT imaging features, intracranial pressure （ICP） and prognosis in patients with moderate or severe traumatic brain injury. Methods ICP monitoring and CT examination were performed in 28 patients with moderate or severe traumatic brain injury. The ICP value and CT imaging features such as the basal cistern compression, midline shift, ventricular compression were recorded, and Rotterdam CT score was calculated. The statistical analyses were performed for these factors. Results The statistical analysis showed： there was a correlation between CT imaging features and ICP level, while the strongest correlation existed between ICP level and Rotterdam CT score. Otherwise, the strongest correlation existed between prognosis and ICP 24 h after injury, while there was not a correlation between both the midline shift and ventricular compression and prognosis. Conduslons Rotterdam CT score is superior to single CT imaging feature for assessing the ICP level and prognosis of patients with moderate or severe traumatic brain injury. There is a negative correlation between ICP level and prognosis after traumatic brain injury, and the ICP monitoring and related treatment can improve the prognosis of patients with moderate or severe traumatic brain injury.