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心肺骤停成功复苏后立即进行的CT检查显示的脑密度与预后相关。

Cerebral density on CT immediately after a successful resuscitation of cardiopulmonary arrest correlates with outcome.

作者信息

Yanagawa Youichi, Un-no Yasushi, Sakamoto Toshihisa, Okada Yoshiaki

机构信息

Department of Trumatology and Critical Care Medicine, National Defense Medical College, Saitama, Japan.

出版信息

Resuscitation. 2005 Jan;64(1):97-101. doi: 10.1016/j.resuscitation.2004.06.015.

Abstract

PURPOSE

To evaluate whether cerebral CT findings taken immediately after successful resuscitation from cardiopulmonary arrest (CPA) correlate with the outcome or not.

MATERIAL AND METHODS

We analyzed retrospectively brain sections with the Housfield unit (CT number). Between May 2001 and March 2004, 16 consecutive patients, who recovered from CPA, were included as subjects in this study. They satisfied all of the following criteria: (a) a helical multislice head CT was performed within 1 h of the return of the spontaneous circulation (ROSC); (b) patients died within 24 h after ROSC, and any patients with trauma or cerebral vascular disease were excluded. The subjects were divided into two groups; those with a cerebral performance category of 1-3 (GR group) and those with a cerebral performance category of 4-5 (VD group).

RESULTS

There were no significant differences between the two groups except for age. The average ventricle size on the brain CT showed no significant difference between the two groups. The average CT number of the putamen and cerebral cortex, and the corticomedullary contrast in the GR group were higher than those in the VD group.

CONCLUSION

Although the influence of age cannot be disregarded, the CT number of the putamen and cortex, and also the corticomedullary contrast correlated with outcome of hypoxic encephalopathy even when cerebral CT was performed within 1 h after ROSC following CPA.

摘要

目的

评估心肺复苏(CPA)成功后立即进行的脑部CT检查结果是否与预后相关。

材料与方法

我们回顾性分析了具有豪斯菲尔德单位(CT值)的脑部切片。在2001年5月至2004年3月期间,16例从CPA中恢复的连续患者被纳入本研究作为受试者。他们满足以下所有标准:(a)在自主循环恢复(ROSC)后1小时内进行螺旋多层头部CT检查;(b)患者在ROSC后24小时内死亡,排除任何有创伤或脑血管疾病的患者。受试者分为两组;脑功能分级为1-3级的患者(GR组)和脑功能分级为4-5级的患者(VD组)。

结果

除年龄外,两组之间无显著差异。脑部CT上的平均脑室大小在两组之间无显著差异。GR组壳核和大脑皮质的平均CT值以及皮质髓质对比度高于VD组。

结论

尽管年龄的影响不容忽视,但即使在CPA后ROSC后1小时内进行脑部CT检查,壳核和皮质的CT值以及皮质髓质对比度也与缺氧性脑病的预后相关。

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