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目的研究CT扫描在儿童轻微脑损伤中的诊断价值。方法选择2012年1月至2015年4月我院急诊科收治的296例钝性脑外伤患儿,无持续性呕吐、记忆缺失及昏迷症状,全部患儿来院后根据病情不同情况进行CT扫描检查。结果 296例患儿处理情况及结局。神经外科干预:1例(0.03%)行开颅术,3例(0.01%)行气管插管。2例(0.06%)骨折处理,未发生1例死亡病例。颅骨骨折:12例(4.0%)颅内血肿,13例(4.3%)蛛网膜下腔出血,下陷性颅骨骨折、硬膜下血肿各1例(0.03%),5例(1.6%)颅内积气,27例(9.1%)脑挫伤,11例(3.7%)硬脑膜外血肿,20例(6.7%)急性脑损伤,16例(5.4%)基底;25例(8.4%)线性。275例电话随访,21例行头颅平片检查,270例行头部CT扫描,其他5例。结论对于轻微脑损伤儿童,特别是并有头痛恶化等危险因素时,及时进行CT扫描可及早发现病情,提高临床治疗效果。
Objective To study the diagnostic value of CT scan in children with mild brain injury. Methods From January 2012 to April 2015, 296 children with blunt traumatic brain injury admitted to our emergency department had no symptoms of persistent vomiting, memory loss and unconsciousness. All children were hospitalized for CT scan according to different conditions . Results 296 cases of children with treatment and outcome. Neurosurgery intervention: 1 case (0.03%) craniotomy, 3 cases (0.01%) tracheal intubation. In 2 cases (0.06%) fractures, 1 case of death did not occur. One patient (0.03%) had cranial fracture: 12 patients (4.0%) had intracranial hematoma, 13 patients (4.3%) had subarachnoid hemorrhage, subsidence skull fracture and subdural hematoma Twenty-six patients (6.7%) had acute brain injury, and 16 (5.4%) had basal ganglia. Twenty-five patients (8.4%) were linear. 275 cases were followed up by phone, 21 cases were examined by skull radiography, 270 cases were performed CT scans, the other 5 cases. Conclusion For children with mild brain injury, especially when there are risk factors such as headache worsening, timely CT scan can detect the disease as soon as possible and improve the clinical curative effect.