颅脑损伤GCS评分与CT像计分与临床预后的相关性研究

The relationships of GCS score and CT score in clinical prognosis in patients with craniocerebral injury

目的探讨颅脑损伤GCS评分与CT像计分与临床预后的相关性,为临床判断颅脑损伤患者预后提供参考。方法随机选取颅脑损伤患者138例,对所有患者均行头颅CT连续扫描并对CT像计分,根据结果将患者分为轻型组（CT像计分≤5分,58例）、中型组（CT像计分6~10分,49例）和重型组（CT像计分≥11分,31例）,并与GCS评分及临床预后进行对照分析。结果 GCS评分分级为轻度昏迷56例,中度昏迷50例,重度昏迷32例,GCS评分与CT像计分比较无明显差异（t=5.234,P〉0.05）,但是随着CT像计分的升高,GCS评分随之下降,二者之间存在显著相关性（r=-0.73,P〈0.05）;58例CT像计分为轻型的患者治疗后,52患者治愈,仅发生轻度残疾或无明显功能障碍,占89.66%;49例CT像计分为中型的患者治疗后,34例患者治愈,仅发生轻度残疾或无明显功能障碍,占57.63%;31例CT像计分为重型的患者治疗后,12例患者治愈,仅发生轻度残疾或无明显功能障碍,占38.71%,组间比较差异显著（P〈0.05）,提示CT像计分与颅脑损伤患者的临床预后存在显著正相关（r=0.37,P〈0.05）。结论颅脑损伤GCS评分与CT像计分存在显著相关性,CT像计分与临床预后存在显著相关性,二者可为临床颅脑损伤患者的预后提高科学参考。

Objective To investigate the correlation between GCS score,CT score and the clinical prognosis in patients with craniocerebral injury,and to provide reference for clinical judgment of prognosis of patients with craniocerebral injury. Methods 138 patients with craniocerebral injury were randomly selected. All patients underwent head CT continuous scanning and CT Score. According to the results,the patients were divided into mild group（ CT score less than or equal to 5 points,58 cases）,medium group（ CT score 6 ~ 10 points,49 cases） and severe group（ CT score more than or equal to 11 points,31 cases）. The GCS and prognosis were compared and analyzed as well. Results The GCS score of patients with mild coma（ 56 case）,moderate coma（ 50 cases） and severe coma score（ 32 case） has no significant difference with CT score,respectively（ t = 5. 234,P〈0. 05）. But with the CT like score increased,GCS score decreased,there was significant correlation between the two（ r =- 0. 73,P〈0. 05）. After treatment,52 patients of 58 cases with CT like scoring as light patientswere cured,only mild disability or no obvious dysfunction,accounting for 89.66%; 34 patients of 49 cases of CT score as medium- sized patients were cured,only mild disability or no obvious dysfunction in 31 cases,accounting for 57. 63%; as for the patients with severe CT score,12 patients were cured,only mild disability or no obvious dysfunction,accounting for 38. 71%,a significant difference between the two groups（ P〈0. 05）,which suggesting that CT like the score and the clinical prognosis of patients with craniocerebral injury were significantly positively correlated（ r = 0. 37,P〈0. 05）. Conclusion Craniocerebral injury with GCS score and CT score are significantly correlated. There is a significant correlation between CT like score and clinical prognosis,and GCS score and CT score can provide scientific reference for the prognosis.