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目的分析急性硬脑膜外血肿患者CT呈现混杂密度影的临床特征及预后。方法回顾性分析278例急性硬脑膜外血肿患者的临床资料。其中,71例CT平扫显示有混杂密度影(混杂密度组),207例CT表现为高密度影(高密度组),比较两组患者的临床和CT资料。结果两组患者年龄、性别构成比、受伤时间和出血量均无统计学差异(P>0.05)。在2~6h的动态CT复查中,混杂密度组患者再次GCS评分下降≥2分和显示出血量增多病例的比例高于高密度组(84.4%vs.43.3%和88.9%vs.45.4%)(P<0.01)。结论 CT呈现混杂密度影的急性硬脑膜外血肿患者,病情呈进行性加重,病死率高,预后差,应行动态CT复查,以便早期实施手术干预,提高救治成功率。
Objective To analyze the clinical features and prognosis of CT in patients with acute epidural hematomas. Methods The clinical data of 278 patients with acute epidural hematomas were retrospectively analyzed. Among them, 71 cases of CT scan showed mixed density (mixed density group), 207 cases of CT showed high density (high density group), the two groups of patients with clinical and CT data. Results There were no significant differences in age, sex ratio, duration of injury and bleeding between the two groups (P> 0.05). In the 2 to 6-h dynamic CT review, patients with mixed densities had a ≥2 second GCS decline and a higher proportion of patients with increased bleeding (84.4% vs.43.3% vs 88.9% vs.45.4% vs P <0.01). Conclusions The patients with acute epidural hematoma presenting with mixed densities showed progressive aggravation, high mortality and poor prognosis. CT should be performed dynamic CT review in order to implement early surgical intervention and improve the success rate of treatment.