急性颅脑创伤后进展性颅内出血的CT表现

CT scan manifestations of progressive intracranial hemorrhage of patients with acute traumaticbrain injury

目的探讨急性颅脑创伤后进展性颅内出血(PIH)发生的CT表现与临床价值。方法回顾性分析我院2009-02—2013-09收治的626例急性颅脑创伤患者的临床资料,分析PIH患者与非PIH患者的CT表现差异以及PIH发生的危险因素。结果单因素回归分析发现,PIH组与非PIH组首次CT表现中颅骨骨折、蛛网膜下腔出血、脑挫裂伤、硬膜外血肿、硬膜下血肿差异有统计学意义(P<0.05)。多因素回归分析发现,颅骨骨折、蛛网膜下腔出血、脑挫裂伤、硬膜外血肿是影响急性颅脑创伤后进展性颅内出血的独立危险因素(P<0.05),蛛网膜下腔出血是最强因素。结论急性颅脑创伤后应尽快进行头颅CT检查,以便尽快确诊PIH及时进行治疗。

Objective To investigate the CT scan manifestations and clinical significance of progressive intracranial hemor-rhage (PTH) of patients with acute traumatic brain injury .Methods The clinical data of 626 patients with acute traumatic brain injury in our hospital from February 2009 to September 2013 were retrospectively analyzed to observe the CT scan mani-festations of PIH and non-PIH patients and the risk factors of PIH .Results Single factor regression analysis showed that there were statistical difference in the CT scan manifestations of PIH and non-PIH patients such as skull fracture ,subarachnoid hemorrhage ,cerebral contusion and laceration ,epidural hematoma ,subdural hematoma .Multivariate regression analysis found that skull fracture ,subarachnoid hemorrhage ,cerebral contusion and laceration ,epidural hematoma were independent risk fac-tor of PIH in patients with acute traumatic brain injury .Conclusion Patients with acute traumatic brain injury should be tested by CT scan as early as possible to confirm PIN in favor of treating PIH timely .