目的 探讨64排螺旋CT对颅脑损伤(TBI)患者诊断的效果及CT评分与认知功能的相关性.方法 选取接受手术治疗的TBI患者138例,以手术病理检查结果为金标准,以格拉斯哥转归评分(GOS)评估预后.比较不同患者CT评分与蒙特利尔认知评估量表(MoCA)和简易精神状态检查量表(MMSE)评分,分析各指标的相关性.结果 入院后3 h内、入院后1 d和入院后第2~3 d 64排螺旋CT检出的灵敏度分别为74.64%、82.61%、98.55%.重度患者 MoCA和 MMSE评分高于中度和轻度患者,中度患者 MoCA和 MMSE评分均高于轻度患者(P<0.05).CT评分与 MoCA和 MMSE评分均呈正相关(P<0.05).重度患者GOS高于中度和轻度患者,中度患者GOS高于轻度患者(P<0.05).结论 64排螺旋CT检测TBI灵敏度较高,CT评分与患者认知功能呈显著正相关,且与患者预后关系密切,可为TBI的临床诊治提供有效依据,意义显著.
Objective To investigate the diagnostic effect of 64-slice spiral CT in patients with traumatic brain injury(TBI),and to evaluate the correlation between CT scores and cognitive function.Methods A total of 138 cases of TBI patients underwent surgical treatment were selected.The surgical pathological examination results were regarded as the gold standard.The prognosis was assessed by Glasgow outcome scale(GOS).The CT scores of all patients were compared by Montreal cognitive assessment(MoCA)and mini-mental state examination(MMSE)scores,and correlation between CT scores and cognitive-related scores was analyzed.Results The sensitivity of 64-slice spiral CT was 74.64%,82.61%and 98.55%within 3 hours,1 day and 2-3 days after admission,respectively.The MoCA and MMSE scores of severe patients were significantly higher than those of moderate and mild patients,and the MoCA and MMSE scores of moderate patients were significantly higher than those of mild patients(P<0.05).CT score was positively correlated with both MoCA and MMSE scores(P<0.05).The GOS of severe patients was significantly higher than that of moderate and mild patients,and the GOS of moderate patients was significantly higher than that of mild patients(P<0.05).Conclusion TBI can be detected with high sensitivity via 64-slice spiral CT.CT score has a significant positive correlation with the cognitive function,and is closely related to the prognosis.It can provide an effective basis for the clinical diagnosis and treatment.