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1、單光子發(fā)射計(jì)算機(jī)斷層掃描在顱腦創(chuàng)傷后的臨床研究 【摘要】目的探索單光子發(fā)射計(jì)算機(jī)斷層掃描(SPECT)在腦外傷評(píng)估及預(yù)后方面的價(jià)值的依據(jù)。方法28例中、重度顱腦損傷患者分別于傷后3天、10天及3~4周接受SPECT、CT檢查及臨床評(píng)定。3個(gè)月后所有患者行腦外傷綜合征的臨床測(cè)試,對(duì)首檢SPECT顯像陽(yáng)性者復(fù)查SPECT,分析首檢SPECT顯像陽(yáng)性者與損傷程度的關(guān)系,動(dòng)態(tài)觀察SPECT顯像與預(yù)后的關(guān)系。結(jié)果SPECT顯像陽(yáng)性與腦損傷程度有關(guān),首檢SPECT顯像陽(yáng)性提示預(yù)后良好,復(fù)查SPECT顯像陽(yáng)性提
2、示多出現(xiàn)腦外傷綜合征。對(duì)幕上損傷患者表現(xiàn)的小腦癥狀、體征可以做出合理的解釋。結(jié)論在中至重度顱腦損傷后SPECT顯像與CT掃描比較更敏感,腦SPECT具有無(wú)創(chuàng)性、功能性及靈敏性高等特點(diǎn),是腦外傷后功能評(píng)估、預(yù)后判斷及臨床研究的可靠方法?! 娟P(guān)鍵詞】腦梗死;局部血流;體層攝影術(shù);發(fā)射型計(jì)算機(jī);單光子 Singlephotonemissioncomputedtomographyimagingforcraniocerebraltrauma 【Abstract】ObjectiveToexploreth
3、evalidityofsinglephotonemissioncomputedtomography(SPECT)imagingintherehabilitationassessmentandprognosticevaluationofpatientswithtraumaticbraininjury(TBI).MethodsTwentyeightpationswithmorderateorsevereTBIunderwentaninitialSPECT,CTandclinicalexaminatio
4、nwithin3days,10daysand3to4weeksafteraclosedheadinjury,andwerereassessed3monthslaterwithclinicalexamination.ThosewhowerewithpostivefindingsintheirinitialSPECTimagingswerereexaminedwithSPECT.ThefindingonSPECTimagesandCTscanwerecompared,andthecorrelation
5、betweenthefindingsorinitialSPECTandactivitybrainlesionswasanalyzed.ResultsItwasfoundthatthepositiverateofinitialSPECTindetectingtheTBIwassignificantlyhigherthanthatofCTscan.WithmorderateorsevereTBIpostiveornegativerateofSPECTimagingwascloselycorrelate
6、dwiththeextentofTBIaswellastheclinicalmanifestationsofthepatients.Wecanexplicatedreasonablywiththesymptomandsyndromeofthecerebellumfromtraumaticbraininjury.ConclusionSPECTimagingissuperiortoCTindetectingintracraniallesionsinpatients.SPECTisnoinvasive,
7、functionalandhighsuperiorityanditispositivemethodoffunctionalassess,recoverandclinicalresearchaftertraumaticbraininjury. 【Keywords】braininfarction;regionalblood5flow;tomography;emission-computed;singlephoton SPECT作為一門新型技術(shù)開(kāi)始在臨床應(yīng)用,具有較高的實(shí)用價(jià)值和指導(dǎo)作用,筆者應(yīng)用S
8、PECT觀察中、重度顱腦損傷后腦血流的變化,現(xiàn)就研究結(jié)果報(bào)告如下?! ?資料與方法 1.1一般資料 28例中重度顱腦損傷患者分別于傷后3天、10天及3~4周接受SPECT檢查,男18例,女10例,年齡19~77歲,平均42.7歲。既往無(wú)顱腦外傷、顱內(nèi)占位病變、腦梗死、HIV、精神病、吸毒、酗酒史。傷后短暫意識(shí)喪失18例(64.3%),持續(xù)昏迷6例(21.4%),肢體偏癱5例(17.9%)。哥拉斯哥評(píng)分重度7例(25%),中度21例(75%)?! ?.2方法SPECTrCBF顯像