脑损伤指数在重型颅脑损伤昏迷患者预后评估中的价值

The research of the craniocerebral injury index on the assessment of prognosis in comatose patients with severe craniocerebral injury

目的研究脑损伤指数(craniocerebral injury idex,CCII,即GCS评分/CT计分比值)对重型颅脑损伤(severe craniocerebral injury,SCCI)昏迷患者的应用及其对预后评估的价值。方法回顾性分析90例SCCI昏迷患者的临床资料,获取GCS评分及对患者头颅CT图像进行Rotterdam CT计分,并分析CCII与患者的病情严重程度及预后的关系。结果预后良好组患者的CCII较预后不良组高,GCS评分6~8分组较3~5分组的CCII明显升高,差异有统计学意义(P<0.05)。患者的CCII与患者GOS预后评分呈正相关(r_p=0.932,P=0.000)。GOS预后评分各组患者之间的CCII从好到差的不同预后呈逐渐递减的趋势,差异具有统计学意义(P<0.05)。结论 CCII有助于评估患者病情、预后及指导临床诊治,具有良好的临床应用价值。

Objective To study the application of craniocerebral injury index（the ratio of GCS/CT score,CCII） in the patients with severe craniocerebral injury（SCCI）,and the effect of CCII on the assessment of prognosis.Methods The clinical data of the patients with SCCI were retrospectively analyzed. The GCS scores and Rotterdam CT scores of CT images,the relationship between the CCII scores and the prognosis,and the relationship between CCII and the severity of the illness were analyzed. Results The CCII scores of the good prognosis group were significantly higher than the those of the poor prognosis group,and the CCII scores of the group with GCS in the range of 6 ～8 were significantly higher than those of the group with GCS in the range of 3 ～ 5（P〈0. 05）. The CCII scores were positively correlated with the GOS（Glasgow Outcome Rating Scale,GOS） scores（Spearman＇ s correlation coefficient rp= 0. 932,P = 0. 000）. From good to poor prognosis,the CCII scores between the patients with different prognoses trended to reduce gradually（P〈0. 05）. Conclusion CCII scores contribute to assess the patients＇ condition,diagnosis,treatment and the prognosis.