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纸质出版:2014
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王科,陈高.颅内出血的轻型颅脑损伤患者计划性CT复查必要性的探讨[J].陆军军医大学学报(原第三军医大学学报),2014,36(04):402-405.
Wang Ke,Chen Gao.Necessity of scheduled repeat cranial computed tomography in mild traumatic brain injury patients with intracranial hemorrhage[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(04):402-405.
目的 研究入院首次行CT检查发现有颅内出血的轻型颅脑损伤患者,有无必要行计划性头颅CT复查。 方法 收集符合标准的病例共117例,分成计划复查组与非计划复查组。计划复查组指伤后即使临床表现稳定,仍在首次CT检查后6 h内、24 h、3、5 d及7 d复查。非计划复查组则在患者出现神经系统症状体征恶化时复查,如无临床表现恶化,则在出院前1 d予以复查。比较2组在入院时的基本资料、首次头颅CT检查结果、影像学进展情况、神经外科专科干预比例、住院天数、出院及预后情况。 结果 2组入院时基本情况、首次头颅CT检查结果比较无明显统计学差异(
P
0.05)。影像学进展比例、进行神经外科专科干预比例、住院天数、出院时GCS评分及6个月后预后评分2组间比较无统计学差异(
P
0.05)。 结论 首次行头颅CT检查发现有颅内出血的轻型颅脑损伤患者,密切观察神经系统症状体征,则可以不必要进行计划性头颅CT复查。
Objective To study the necessity of scheduled repeat cranial computed tomography (CT) scans in patients suffering from mild traumatic brain injury with intracranial hemorrhage based on the first CT scan. Methods One hundred and seventeen patients were divided into a scheduled repeat cranial CT group (scheduled group) and non-scheduled repeat cranial CT group (non-scheduled group). The scheduled group
even if clinically stable
was still required to have repeat cranial CT scans within 6 and 24 h
and 3
5 and 7 d after the first CT scan. The non-scheduled group was required to have repeat CT scans ba
sed on neurologic deterioration or at the day before discharge if no neurologic deterioration was observed. Age
gender
score of Glasgow Coma Scale (GCS) at admission
the result of the initial CT scan
radiographic progression
proportion of neurologic interventions
length of hospital stay
score of GCS at discharge
and prognosis at six month after injury were compared between the groups. Results There was no significant difference in age
gender
score of GCS at admission
the result of the initial CT scans
radiographic progression
proportion of neurologic interventions
length of hospital stay
score of GCS at discharge
and prognosis between the 2 groups (
P
0.05). Conclusion Scheduled repeat cranial CT scans are unnecessary in patients suffering from mild traumatic brain injury with identified intracranial hemorrhage based on the first CT scan after injury
if being closely monitored.
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