Brown C E, Purdy P, Cunningham F G
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical School, Dallas 75235.
Am J Obstet Gynecol. 1988 Oct;159(4):915-20. doi: 10.1016/s0002-9378(88)80170-4.
From 1980 to 1986, head computed tomographic scans were performed in 49 women with eclampsia managed according to the standardized regimen used at Parkland Memorial Hospital. Abnormal radiographic findings were seen in 14 (29%). Although this incidence may have been affected by the temporal relationship of the scan to the seizure, it was greatly impacted by technical resolution obtained with succeeding improved equipment. In the last 3 years of the study more than a third of these scans showed some abnormality, and in 1986, using "fourth-generation" equipment, half were abnormal. These areas of radiographic hypodensity correspond to those with petechial hemorrhages and local edema that have been described at autopsy in women who died after eclamptic episodes. All women recovered fully despite ominous findings in some. We conclude that the clinical utility of tomography in women with otherwise "uncomplicated eclampsia" is limited because these findings seldom alter management.
1980年至1986年期间,对49例按照帕克兰纪念医院标准化方案治疗的子痫妇女进行了头部计算机断层扫描。14例(29%)出现异常影像学表现。尽管这一发生率可能受到扫描与癫痫发作时间关系的影响,但很大程度上受到后续改进设备所获得的技术分辨率的影响。在研究的最后3年,超过三分之一的扫描显示有一些异常,1986年使用“第四代”设备时,一半扫描结果异常。这些影像学低密度区域与子痫发作后死亡女性尸检时所描述的瘀点出血和局部水肿区域相对应。尽管有些检查结果不祥,但所有女性均完全康复。我们得出结论,对于其他方面“无并发症子痫”的女性,断层扫描的临床实用性有限,因为这些检查结果很少改变治疗方案。