[CT扫描在小儿头部损伤中的相关性]
[Relevance of CT-scans for pediatric head injuries].
作者信息
Maier B, Maier-Hemming A, Lehnert M, Mutschler W E, Marzi I, Rose S
机构信息
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Zentrum der Chirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt.
出版信息
Unfallchirurg. 2003 Mar;106(3):220-5. doi: 10.1007/s00113-002-0546-9.
AIM OF THE STUDY
Clinical evaluation of pediatric head injury is quite difficult and often cranial CT scans are performed. We investigated the relevance of CT scans in relation to the therapeutic outcome.
METHODS
During a 5-year-period we retrospectively evaluated the results of x-ray and cranial CT scan in respect to primary clinical assessment and degree of head injury.
RESULTS
From 408 children classified as mild head injury (GCS 15-13) 217 received CT scans with 2 presenting pathological intracranial findings, none of these children required neurosurgical treatment. Out of 29 children suffering from severe head injury (GCS <12) 12 suffered from intracranial bleeding, and 17 had intracranial bleeding and a skull fracture.
CONCLUSION
Children encountering mild head injury combined with primary loss of consciousness or vomiting, require hospitalisation. Initial CCT did not lead to therapeutic consequences in this group. Children classified as severe head injury or multiple traumatized children need immediate cranial CT scan and hospitalisation.
研究目的
小儿头部损伤的临床评估颇具难度，通常需进行头颅CT扫描。我们调查了CT扫描与治疗结果的相关性。
方法
在5年期间，我们回顾性评估了X线和头颅CT扫描结果与初始临床评估及头部损伤程度的关系。
结果
在408名被归类为轻度头部损伤（格拉斯哥昏迷评分15 - 13分）的儿童中，217人接受了CT扫描，其中2人颅内检查结果异常，但这些儿童均无需神经外科治疗。在29名重度头部损伤（格拉斯哥昏迷评分<12分）的儿童中，12人颅内出血，17人颅内出血并伴有颅骨骨折。
结论
轻度头部损伤合并初始意识丧失或呕吐的儿童需要住院治疗。该组患者最初的头颅CT检查未导致治疗方案的改变。被归类为重度头部损伤或多发伤的儿童需要立即进行头颅CT扫描并住院治疗。
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