单光子发射计算机断层显像在颅脑损伤昏迷患者意识状态评估中的临床应用价值

The value of evaluating the conscious state in patients of coma with traumatic brain injury by single photon emission computerized tomography

目的:探究单光子发射计算机断层显像(SPECT)在颅脑损伤昏迷患者意识状态评估中的临床应用价值。方法:选取颅脑损伤昏迷患者64例,其中男48例,女16例,治疗前患者GCS评分平均6.69±1.39分。分别于治疗前及治疗后4周观察所有患者的GCS评分、SPECT视觉分析及半定量分析。结果:治疗后患者GCS评分平均10.09±2.78分,患者GCS评分与治疗前比较,其差异有显著性意义(P<0.05);SPECT视觉分析提示患者病灶区脑血流量较治疗前有不同程度增加;半定量分析比值结果提示患者的绝对值为18.74±11.63,较治疗前的48.40±11.90,变化量为-29.66±11.35,其差异具有显著性意义(P<0.05);治疗前后GCS评分变化量与半定量分析比值绝对值变化量具有显著相关性(P<0.05)。结论:SPECT半定量分析比值绝对值变化量可相对客观地反映颅脑损伤昏迷患者治疗前后意识状态水平变化情况,在一定程度上与GCS评分形成互补,对颅脑损伤昏迷患者意识状态具有一定的评估价值。

Objective: To explore the value of evaluating the conscious state in patients of coma with traumatic brain injury by single photon emission computerized tomography (SPECT). Method: Sixty-four patients (48 males and 16 females) of coma with traumatic brain injury were selected. The average pre-treatment Glasgow coma scale (GCS) score was 6.69±1.39. The GCS score, SPECT visual analysis and semi-quantitative analysis of all patients were observed pre-treatment and post-treatment. Result: Post- treatment, the GCS score of patients was 10.09 ± 2.78. GCS score of all patients post- treatment was significant different compared with that of pre- treatment (P<0.05). The results of SPECT visual analysis showed that cerebral blood flow in the lesion area of all patients increased to some extent compared with that of pre-treatment. The results of semi-quantitative analysis indicated that the absolute value was 18.74±11.63, decreased by 29.66±11.35 compared with that of pre-treatment (48.40±11.90). The absolute value of semi-quantitative analysis was statistically significant (P<0.05) compared with that of pre- treatment. The change of GCS score was related with that of semi-quantitative analysis(P<0.05). Conclusion: The changes of SPECT semi- quantitative analysis can objectively reflect the change of the conscious state of patients of coma with traumatic brain injury, which is complementary to GCS score. It was valuable to evaluate the conscious state of patients of coma with traumatic brain injury by SPECT.