摘要
目的分析CT平扫判断急性硬膜 外血肿“漩涡征”的影像学意义与患者 预后。方法 选取2013年1月到2014年12 月在我院接受治疗的急性硬膜外血肿共 42例,根据颅脑CT有无漩涡征分为:涡旋 征组22例,非涡旋组20例。及时对患者 行手术治疗,观察患者术后恢复情况。 结果 经过手术治疗后患者的GCS评分均 不同程度的提高,差异具有统计学意义 (P均<0.05),两组术后GCS评分比较, 差异具有统计学意义(P=0.037);两组病 死率、治愈率比较,差异具有统计学意 义(χ2 =9.31,8.28,P<0.05)。结论 CT 平扫对于检查急性硬膜外血肿患者意义 重大,若显示“漩涡征”应对患者尽早 行急诊手术,提高患者生存率。
Objective To analysis the imaging significance of "whirlpool" sign of acute epidural hematoma on CT scan and the correlation study between "whirlpool" sign and the prognosis. Methods A total of 42 cases of acute epidural hematoma patients treated in our hospital from January 2013 to December 2014 were includeed in the study, all patients were on CT scan, and received surgical treatment, observed the postoperative recovery. The 42 cases were divided into two group, "whirlpool" group(22 cases) and the "without whirlpool" group(20 cases). Results The GCS score after operation was significantly higher than preoperative, the difference was statistically significant (P<0.05); and there was difference between the "whirlpool" group and the " without whirlpool" group, P<0.05. There was statistically difference of fatality rate and the recovery rate between the two groups (χ2 =9.31, 8.28, P<0.05). Conclusions CT scan was significant for the diagnosis of acute epidural hematoma, and it’s better to received surgical treatment if the patients combine with “whirlpool” sign, which would improve the survival rate of patients
【关键词】CT平扫;急性硬膜外血肿; 漩涡征;开颅血肿清除术
【中图分类号】R651.15;R814.42
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.02.010
前言
急性硬膜外血肿指的是在颅骨内板与硬脑膜之间发生的血肿,多 发于线性骨折病人,据统计,有25%以上的外伤性颅内血肿患者为急性 硬膜外血肿,仅次于硬膜下血肿[1-2]。一般情况下,诊断明确且及时接 受手术的急性硬膜外血肿患者均能得到有效的治疗,且预后较好,但 若患者CT平扫结果显示“漩涡征”则其预后普遍较差[3]。“漩涡征” 是指患者CT平扫显示颅脑和硬膜间高密度的硬膜外血肿中出现圆形的 低密度区域。现将笔者对CT平扫判断急性硬膜外血肿“漩涡征”的影 像学意义及患者预后分析报道如下。
中国CT和MRI杂志
第14卷, 第 2 期
2016年02月
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