创伤性急性硬膜下血肿一些CT改变与GCS、预后关系的对比研究

A contrast study on the relationship of some CT changes with GCS and prognosis of traumatic acute subdural hematoma

目的 了解创伤性急性硬膜下血肿一些CT改变与哥拉斯哥昏迷评分 (GCS)及预后的相关性 ,比较其中的差异。方法 复习 5 4例创伤性急性硬膜下血肿的CT特征 ,采用 χ2 检验 ,从血肿最大厚度、中线移位程度、基底池闭塞、蛛网膜下腔积血、局部脑挫裂伤、远隔部位脑挫裂伤中确定与GCS及预后相关的因素。结果 与GCS相关的因素为中线移位、基底池闭塞和远隔部位脑挫裂伤 ,与预后相关的因素为基底池闭塞及远隔部位脑挫裂伤。结论 远隔部位脑挫裂伤反映了弥漫性脑伤的伤情 ,治疗干预性差 ,是影响意识状况和预后的共同基础之一 ;脑变形的影像改变尽管与意识状况密切相关 ,但由于有一定的治疗可干预性 。

Objective To explore the relationship of some CT changes with GCS and prognosis of traumatic acute subdural hematoma, and analyze the differences between them.Method CT charateristics of 54 cases with traumatic acute subdural hematoma were reviewed. The variates related to GCS and prognosis of traumatic acute subdural hematoma were determined from the following variates: maximal thickness of subdural hematoma, midline shift,basal cisterns obturation, subarachoid bleeding, local and distant brain contusion by X 2 test.Result The variates significantly related to GCS were midline shift,basal cisterns obturation and distant brain contusion.The variates significantly related with prognosis were basal cisterns obturation and distant brain contusion.Conclusion The distant brain contusion representing characteristics of diffuse brain and difficultly to be reversed is the common base of the effected consciousness and prognosis.Brain shape changes is related to GCS,but it may not affect prognosis because of its therapeutic reverse to some extent.