重型颅脑损伤患者早期头颅CT影像学特点分析

目的探讨重型颅脑损伤预后相关的早期头颅CT影像学特点。方法回顾性分析106例重型颅脑损伤患者伤后6h内的头颅CT表现,依据出院时格拉斯哥结果分级(GOS)标准分为预后良好组和预后不良组,分析预后相关的早期头颅CT影像学特点。结果单因素分析表明,2组轻-中度局灶性脑损伤和重度弥漫性脑损伤、环池-基底池受压或闭塞有显著性差异(P<0.05);多因素分析显示,重度弥漫性脑损伤(OR=0.108,P=0.018)是预后独立相关的头颅CT表现,硬膜外血肿(OR=3.743,P=0.020)、环池-基底池受压或闭塞(OR=0.106,P=0.000)是预后独立相关的头颅CT影像学特点。结论重型颅脑损伤早期头颅CT表现与预后关系密切,了解其特点有助于合理制定治疗方案和评估预后。

Analysis of early head CT features of patients with severe head injury

Objective To investigate early head CT features related to the prognosis of patients with severe head injury.MethodsOne hundred and six patients were divided into good outcome group and bad outcome group according to Glasgow outcome scale(GOS)at 3 months after injury.Head CT scans were performed within the first 6 hours of injury and the relationship between the CT findings and prognosis were retrospectively analyzed.Results Univariate analysis revealed that mild-moderate focal injury,severe diffuse injury,compressed or absent basal-perimesencephalic cisterns were significantly different between the two groups(P<0.05).Multivariate analysis revealed that severe diffuse injury(OR=0.108,P=0.018)was the independent CT appearance related to prognosis.Extradural haematoma(OR=3.743,P=0.020)and compressed or absent basal-perimesencephalic cisterns(OR=0.106,P=0.000)were independent CT features related to prognosis.Conclusion Early head CT appearance has close relationship to the prognosis of patients with severe injury.Undstanding the features is helpful to the treatment and prognosis assessment.