颅脑损伤术后复查CT对改善预后价值探讨

Value of CT reexamination on the prognosis improvement in patients with postoperative craniocerebral injury

目的探讨颅脑损伤术后复查CT对改善预后的价值。方法收集该院颅脑损伤手术患者120例(术后8h内均复查CT),将其随机分为定期复查组(术后3d、7d计划性复查CT)69例,对照组(未复查,含非计划性复查)51例。记录术前、术后7d、出院时格拉斯哥昏迷指数(GCS)评分、术后临床症状、二次手术、住院天数、住院存活以及伤后6个月格拉斯哥预后评分(GOS)情况。结果术后8h内、3d、7dCT发现明显异常者中,分别有48.8%、76.9%、75.0%的患者伴有临床症状。定期复查组二次手术率低于对照组,差异有统计学意义(P=0.043);其术后7dGCS、伤后6个月GOS评分显著高于对照组,而住院天数较对照组明显缩短,差异均有统计学意义(P<0.05)。结论颅脑损伤术后定期复查CT有助于改善患者预后,具有临床应用价值。

Objective To explore the value of CT reexamination on the prognosis improvement in patients with postoperative craniocerebral injury.Methods Totally 120 patients with craniocerebra injury who had experienced craniotomy were selected in this study and all the patients accepted CT reexamination in 8h after operation.Among all the patients,69 patients who accepted planning CT in 3d and 7d after operation were classified as the regular reexamination group while the other 51 patients were in the control group.GCS scores（before and 7d after operation）,symptoms after operation,times of re-operation,hospitalization days,death rates and GOS scores at 6 months after injury were recorded and compared between the groups.Results In the patients with obviously abnormal CT at 8h,3d and 7d after operation,only 48.8%,76.9% and 75.0% of the patients were with clinical symptoms respectively.The re-operative rate of the regular reexamination group was significantly lower than that of the control group（P=0.043）,while both the GCS scores of 7d after operation and the GOS scores at 6 months after injury were significantly higher than control group（P〈0.05）.The hospitalization days of the regular reexamination patients were significantly shorter than that of the control group（P〈0.05）.Conclusion Regularly postoperative CT reexaminations in craniocerebral injury patients are beneficial for improving the prognosis,which is valuable in clinical application.