一些CT特征在创伤性急性硬膜下血肿术后变化及与预后的关系

The postoperative changes in occurrence of some CT charateristics of traumatic acute subdural hematomas and their relationship with prognosis.

目的 探讨一些 CT特征在创伤性急性硬膜下血肿手术后的变化及与预后的关系。方法 复习 45例创伤性急性硬膜下血肿手术前后的 CT及临床特征。采用 χ2检验 ,以有否中线移位程度、蛛网膜下腔积血、基底池闭塞、局部脑挫裂伤、远隔部位脑挫裂伤等为对象 ,确定这些特征于手术后发生的改变及与预后的关系。结果 术前中线移位和基底池闭塞发现率较高 ,而术后远隔部位脑挫裂伤发现率较高。与预后显著相关的因素为远隔部位脑挫裂伤。结论 术前 CT不能充分反映急性硬膜下血肿的伤情及预后 ,术后及时复查

Objective To explore the postoperative changes in occurrence of some CT charateristics of traumatic acute subdural hematomas and detect their relationship with prognosis.Methods The clinical and CT charateristics of 45 cases of traumatic acute subdural hematoma before and after operation were reviewed.The target variables were:midline shift,subarachoid hemorrhage,basal cisterns obturation,local and distant brain contusion.Before and after comparison on the variables was performed using chi square test to determine the signifcance of changes.OR was used to indicate the association of variables with prognosis.Results The occurrence percentages of midline shift and basal cisterns obturation were significantly higher before operation.In contrast,the occurrence percentage of distant brain contusion was significantly higher after operation.Distant brain contusion was significantly associated with prognosis(OR=18.3).Conclusion Preoperative CT can not fully depict the injury condition and the prognosis of traumatic acute subdural hematoma,so timely postoperative CT is needed.