急诊科头外伤CT检查方案的制定及价值

The value of CT and program for head trauma in emergency department

目的评估急诊科头外伤CT检查方案的制定及其临床实用价值。方法采用配对随机试验比较4 531例轻微脑外伤的临床预后,主要结局为头部CT扫描转诊。结果对照组与干预组的基线特征相似。干预组中转诊CT扫描患者比例由“前”期的(62.8%)增加到“后”期的(76.2%),对照组中转诊CT扫描比例亦从67.5%增加到74.1%。平均扫描率变化二者比较差异无统计学意义(P=0.16);无漏诊脑损伤或不良结局。结论急诊科头CT检查方案对临床指导轻微脑外伤的处理有一定临床意义。

Objective To evaluate the value of CT and program for head Trauma in Emergency Department.Methods A matched randomized trial was used to compare the clinical prognosis of 4 531 cases of mild brain injury.The main outacome was head CT scan referrals.Results The baseline characteristics of the control group were similar to those of the intervention group.The proportion of patients referred to CT increased from 62.8%to 76.2%in the intervention group,and that in the control group also increased from 67.5%to 74.1%,there was no significant difference in the average scanning rate between the two groups(P=0.16).No brain injury or adverse outcome was detected.Conclusion CT program in the head of emergency department does not decrease the rate of CT,and it is of clinical significance in guiding the management of mild brain injury.