CAJ | 학술논문

目的：将CT影像表现进行数据化，分析重型颅脑损伤(sTBI)去骨瓣减压术患者的影响因素，评价其与预后的关系。方法回顾性分析2011年1月至2013年6月北京军区总医院附属八一脑科医院收治的121例重型颅脑损伤去骨瓣减压患者的临床资料，研究CT影像表现数据值变化，并分析年龄、受伤-手术时间间隔、入院格拉斯哥昏迷评分(GCS)、瞳孔直径等因素对患者预后的影响，预后以6个月时的格拉斯格预后(GOS)评分判断。结果预后良好组(GOS 3~5分)共75例，预后不良组(GOS 1~2分)共46例。两组间在CT数据值(3.55±0.92和4.51±0.96，t=19.221，P=0.000)以及年龄(39.12±6.42和53.93±8.64，t=27.257，P=0.000)、受伤至手术时间间隔(35.75±7.86和9.43±2.15，t=11.712，P=0.000)、入院GCS评分(6.40±1.52和4.54±1.11，t=25.147，P=0.000)、瞳孔直径(2.81±0.49和3.57±1.02，t=39.579，P=0.000)等方面差异均具有统计学意义。结论术前头颅CT影像数据化后可与年龄、受伤-手术时间间隔、入院GCS评分、瞳孔变化等一起作为评价脑外伤预后的重要临床参考指标。
목적：장CT영상표현진행수거화，분석중형로뇌손상(sTBI)거골판감압술환자적영향인소，평개기여예후적관계。방법회고성분석2011년1월지2013년6월북경군구총의원부속팔일뇌과의원수치적121례중형로뇌손상거골판감압환자적림상자료，연구CT영상표현수거치변화，병분석년령、수상-수술시간간격、입원격랍사가혼미평분(GCS)、동공직경등인소대환자예후적영향，예후이6개월시적격랍사격예후(GOS)평분판단。결과예후량호조(GOS 3~5분)공75례，예후불량조(GOS 1~2분)공46례。량조간재CT수거치(3.55±0.92화4.51±0.96，t=19.221，P=0.000)이급년령(39.12±6.42화53.93±8.64，t=27.257，P=0.000)、수상지수술시간간격(35.75±7.86화9.43±2.15，t=11.712，P=0.000)、입원GCS평분(6.40±1.52화4.54±1.11，t=25.147，P=0.000)、동공직경(2.81±0.49화3.57±1.02，t=39.579，P=0.000)등방면차이균구유통계학의의。결론술전두로CT영상수거화후가여년령、수상-수술시간간격、입원GCS평분、동공변화등일기작위평개뇌외상예후적중요림상삼고지표。
Objective To explore CT image datamation as the outcome related factors of the patients with severe traumatic brain injury (sTBI) following decompressive craniectomy, and evaluate the relation between outcomes and the factors. Methods During January 2011 to June 2013, 121 TBI patients underwent decompressive craniectomy were selected for analysis. CT image datamation, age, interval of the injury to operation, admit Glasgow coma score (GCS), pupil diameter as well as the outcome influenced by them were evaluated. The prognosis was evaluated according to Glasgow outcome scale(GOS). Results Through statistical analysis, CT image datamation, age, interval of injury to operation, GCS, and pupil diameter are all close correlated with outcome(P<0.05). Conclusions CT image datamation, ages, interval of the injury to operation, admit GCS and pupil diameter could be generally applied as indicators to assess the outcome of TBI patient.