摘要
目的 探讨急诊科头颅CT扫描在不同年龄组和不同转诊适应证的患者中检出急性病变的情况。方法回顾性分析2022年7月20日—2022年8月19日在中南大学湘雅医学院附属海口医院急诊科首诊后立即行头颅CT的769例成年患者,根据CT结果分为急性病变、慢性病变和正常三组,并按年龄分为18~40岁、41~65岁和65岁以上三组,收集患者基本资料,计算各转诊适应证与急性病变的相关性。结果 本研究共纳入了769例急诊科头颅CT扫描患者,通过头颅CT检测后检出共有119例患者检出急性病症。统计学分析结果显示急性病症的发生率随着年龄的增长而增加(P<0.05),最常见的急性病症是脑出血(29.41%)、缺血性梗塞(26.89%)、肿块(22.69%);前三个转诊适应证是局灶性神经功能缺损(29.26%)、头部损伤(包括疑似骨折或出血)(24.58%)和头痛(17.63%);不同转诊适应证的急性病症检出率分别为癫痫发作(22.50%)、意识模糊(19.67%)、晕厥(17.19%)、局灶性神经功能缺损(14.34%)、头部损伤(15.61%)、头痛(11.56%)和头晕(9.59%)。结论 急诊科头颅CT扫描对于发现不同年龄组和不同转诊适应证的急性病变具有重要价值,其中癫痫发作是高收益转诊适应证,而头晕是低收益转诊适应证。本研究可为制定急诊科头颅CT扫描的临床指南提供参考依据。
Objective To investigate the detection of acute lesions by head CT scan in emergency department patients of different age groups and with different referral indications.Methods A retrospective analysis was conducted on 769 adult patients who underwent head CT immediately after their first medical contact in the emergency department of Haikou Hospital Affiliated to Xiangya Medical College of Central South University from July 20,2022 to August 19,2022.The patients were divided into three groups according to the CT results:acute lesions,chronic lesions and normal.They were also divided into three age groups:18-40 years old,41-65 years old and over 65 years old.The basic information of the patients was collected and the correlation between the referral indications and acute lesions was calculated.Results A total of 769 patients who underwent head CT in the emergency department were included in this study,and 119 patients were detected with acute lesions after head CT examination.Statistical analysis showed that the detection rate of acute lesions increased with age(P<0.05).The most common acute lesions were cerebral hemorrhage(29.41%),ischemic infarction(26.89%)and mass(22.69%).The top three referral indications were focal neurological deficit(29.26%),head injury(including suspected fracture or hemorrhage)(24.58%)and headache(17.63%).The detection rates of acute lesions for different referral indications were as follows:seizure(22.50%),altered mental status(19.67%),syncope(17.19%),focal neurological deficit(14.34%),head injury(15.61%),headache(11.56%)and dizziness(9.59%).Conclusion Head CT scan in emergency department is valuable for detecting acute lesions in patients of different age groups and with different referral indications,among which seizure is a high-yield referral indication,while dizziness is a low-yield referral indication.This study provides a reference for developing clinical guidelines for head CT scan in emergency department.
作者
谢兴润
李香营
XIE Xingrun;LI Xiangying(Radiology Department,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine,Haikou Hainan 570208,China)
出处
《中国急救复苏与灾害医学杂志》
2023年第8期1056-1059,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
海南省卫健委重点课题(编号:20201112)。
关键词
螺旋计算机断层扫描
急诊科
头颅CT
急症检出率
Spiral computed tomography
Emergency department
Head CT
Emergency detection rate
作者简介
通信作者:李香营,E-mail:lxydoc@126.com。
