早期胸部CT扫描在颅脑创伤合并胸部损伤中的应用

目的 探讨早期胸部CT扫描在重型颅脑创伤合并胸部损伤诊断中的临床应用效果.方法 收集两家医院2000年1月-2008年12月间收治的163例重型颅脑创伤合并胸部损伤患者的临床资料,按早期检查方法将患者分为A、B两组.A组:早期头部CT扫描加胸部X线片(2000年1月-2006年10月);B组:早期头部、胸部CT平扫(2006年10月-2008年12月),比较救治效果.结果 A组84例,年龄(49±20)岁;B组79例,年龄(48±18)岁.A组肺部感染25例(30%),B组肺部感染10例(13%);A组9例(11%)发生ARDS,B组1例(1%)发生ARDS;A组发生神经源件肺水肿8例(10%),B组1例(1%);A组患者平均昏迷时间41 d,B组15 d.结论 早期胸部CT扫描有助于明确重型颅脑创伤合并胸部损伤的诊断,从而降低肺部感染、ARDS、神经源性肺水肿的发生率,有助于缩短昏迷时间,提高救治效果.

Clinical application of early chest CT examination in patients with traumatic brain injury combined with chest injury

Objective To discuss the clinical effect of early chest CT examination in patients with traumatic brain injury combined with chest injury. Methods A total of 163 patients with traumatic brain injury combined with chest injury treated in two hospitals between 2000 and 2008 were involved in the study and divided into two groups according to different early examination methods, ie, Group A (ear-ly head CT and chest X-ray from January 2000 to October 2006) and Group B (early head and chest CT from October 2006 to December 2008) for a comparative study. Results The patients were at age of (49±20) years in Group A and at (48±18) years in Group B. Lung infection occurred in 25 patients (30%) in Group A and 10 (13%) in Group B. ARDS occurrod in nine patients (11%) in Group A and one (1%) in Group B. Neurogenic pulmonary edema occurred in eight patients (10%) in Group A and one (1%) in Group B. The coma lasted for average 41 days in Group A and 15 days in Group B. Con-dusion Early chest CT examination has great help for clear diagnosis of traumatic brain injury combined with chest injury and hence can reduce lung infection, ARDS and neurogenic pulmonary edema, shorten coma time and improve curative effect.