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目的 探讨高原低氧环境下颅脑损伤的CT特点 ,以提高高原地区颅脑损伤的CT诊断水平。材料和方法 回顾我院 (海拔36 58米 ) 1 994年以来有明确外伤史、CT资料完整、部分经手术证实的颅脑外伤病例838例。所有病例的CT片均由两名放射科医师独立阅片。 358例CT检查阳性患者中男性 30 1例、女性 57例 ,汉族 1 73例、藏族 1 83例、回族 2例 ,年龄最小 2月、最大82岁 ,平均 2 7 2± 1 4 6岁。结果 838例颅脑外伤患者的CT检查的阳性率为4 2 7%。硬膜下血肿 96例 ( 2 6 8% ) ,硬膜外血肿 59例 ( 1 6 5% ) ,硬膜下、外混合血肿 3例 ;脑挫裂伤 1 83例 ( 51 1 % ) ,其中脑挫裂伤合并血肿形成 1 0 1例 ,颅骨骨折1 84例 ( 51 4 % ) ,其中单纯颅骨骨折 37例、硬膜下血肿合并颅骨骨折 34例、硬膜外血肿合并颅骨骨折 33例、硬膜下、外混合血肿合并颅骨骨折 2例、脑挫裂伤合并颅骨骨折 57例、其它类型损伤合并颅骨骨折 2 1例。结论 高原地区颅脑损伤有着与平原地区不同的特点 :各种损伤的发生率不同 ,损伤程度较平原地区严重。本文的统计结果与CT应用于高原以前的颅脑损伤的统计结果有着极大的差别 ,说明CT在高原地区颅脑损伤的诊断中起着非常重要的作用。
Objective To investigate the CT features of craniocerebral injury under high altitude hypoxia so as to improve the CT diagnosis of craniocerebral injury in the plateau. Materials and Methods Review our hospital (36 58 meters above sea level) since 1994 a clear history of trauma, CT data integrity, some of the 838 cases of traumatic brain injury confirmed by surgery. CT radiographs were read independently by two radiologists in all cases. Of the 358 CT-positive patients, there were 30 males and 57 females, including 1 73 Han cases, 1 83 Tibetan cases and 2 Hui nationality patients. The youngest females and the females aged 82 and older were 272 ± 146 years old. Results The positive rate of CT in 838 cases of traumatic brain injury was 42.7%. There were 96 cases (26.8%) of subdural hematoma, 59 cases (156%) of epidural hematoma, 3 cases of subdural and extramural hematoma, and 1 83 cases (51 1%) of cerebral contusion and laceration There were 101 cases of cerebral contusion and hematoma, and 1 84 cases of skull fracture (51 4%), of which 37 cases were simple skull fracture, 34 cases were subdural hematoma with cranial fracture, 33 cases were epidural hematoma with skull fracture, Subdural and extramural hematomas combined with skull fracture in 2 cases, brain contusion and laceration in 57 cases of skull fracture, other types of injuries with skull fracture in 21 cases. Conclusion The brain injury in the plateau has different characteristics from the plains: the incidence of various injuries is different, and the degree of injury is more serious than that in the plain. The statistical results of this paper and CT before the application of the brain injury before the statistical results are very different, indicating CT in the high altitude brain injury diagnosis plays a very important role.