目的 探讨多层螺旋CT在重症监 护病房(ICU)老年颅脑出血伴昏迷患者 救治中的应用价值。方法 选取2013年7 月-2015年7月发病24h内入住神经外科 ICU老年颅脑出血伴昏迷的患者49例作 为研究对象，分析其CT表现及与预后的 关系。结果 本组49例颅脑血肿伴昏迷患 者15例死亡，占30.61%。血肿部位以基 底节区最为常见(55.10%)；31例血肿形 态规则(63.27%)，18例血肿形态不规则 (36.73%)；26例出血量＜30mL(53.06%)， 14例出血量为30-60mL(28.57%)，9 例出血量＞60mL(18.37%)，死亡率 分别为11.54%、35.71%、77.78%； 20例无中线移位(40.82%)，16例中 线移位≤5mm(32.65%)，9例中线 移位6-10mm(18.37%)；4例移位＞ 10mm(8.16%)，死亡率分别为10.0%、 31.25%、55.56%、75.0%。结论 多层螺旋 CT可清晰显示老年颅脑损伤伴昏迷患者血 肿部位、血肿量、中线移位情况，对预后 有一定预测价值。

Objective To explore the application value of multi-slice spiral CT in the treatment of elderly patients with cerebral hemorrhage complicated with coma in intensive care unit (ICU). Methods A total of 49 cases of elderly patients with cerebral hemorrhage accompanied by coma in Department of Neurosurgery 24h in July 2013 -2015 July were selected as the research objects, and the relationship between CT manifestations and prognosis of ICU was analyzed. Results Among the 49 cases, 15 cases with cerebral hematoma complicated with coma died, accounting for 30.61%. The most common area of hematoma was basal ganglia (55.10%). 31 cases of hematoma was regular (63.27%), and 18 cases were irregular (36.73%). The bleeding volume of 26 cases (53.06%) was < 30mL, 14 cases (28.57%) 30-60mL and 9 cases (18.37%) ＞ 60mL. The mortality rates were 11.54%, 35.71% and 77.78% respectively. There were 20 cases without midline shift (40.82%), 16 cases with midline shift ≤ 5mm (32.65%), 9 cases with midline shift 6 to 10mm (18.37%) and 4 cases with shift ＞ 10mm (8.16%). The mortality rates were 10.0%, 31.25%, 55.56% and 75.0%, respectively. Conclusion Multi-slice spiral CT can clearly show the location, volume of hematoma, and whether the middle line shift in elderly patients with craniocerebral injury and coma.