实用临床医药杂志2025，Vol.29Issue(8)：17-21,5.DOI:10.7619/jcmp.20246116
头颅CT环池分级、D-二聚体及格拉斯哥昏迷量表评分对重型颅脑损伤患者术后近期预后的预测价值
Value of cranial CT cisternal grading,D-dimer,and Glasgow Coma Scale score in predicting short-term postoperative prognosis in patients with severe traumatic brain injury
摘要
Abstract
Objective To investigate the value of cranial CT cisternal grading combined with D-dimer(D-D)and Glasgow Coma Scale(GCS)score in predicting the short-term postoperative prog-nosis of patients with severe traumatic brain injury.Methods A total of 165 patients with severe trau-matic brain injury who were treated in the hospital from January 2019 to May 2024 were selected as study subjects,all underwent craniotomy surgery.Postoperative follow-up was conducted for 3 months to analyze the differences in clinical data and preoperative indicators such as cranial CT cisternal grad-ing,D-D levels,and GCS scores between patients with poor and good prognosis.The value of cranial CT cisternal grading,D-D levels,and GCS scores in predicting short-term postoperative poor prognosis in patients with severe traumatic brain injury was also analyzed.Results Compared with patients with good prognosis,patients with poor prognosis had higher proportion of age,cranial CT cisternal grading of Ⅰ to Ⅱ,D-D levels,and GCS scores＜6(P＜0.05).There were no statistically significant differences in C-reactive protein,prothrombin time,activated partial thromboplastin time,international normalized ratio,total cholesterol,triglycerides,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol levels between patients with poor and good prognosis(P＞0.05).Cranial CT cisternal grading,D-D levels,and GCS scores were influencing factors for short-term postoperative poor prognosis in patients with severe traumatic brain injury(P＜0.05).The area under the curve for poor prognosis by three indicators in combination was 0.941(95％CI,0.906 to 0.975),which was higher than the area under the curve for the individual predictions of cranial CT cisternal grad-ing,D-D levels,and GCS scores(P＜0.05).Conclusion The influencing factors for short-term postoperative prognosis in patients with severe traumatic brain injury include cranial CT cisternal grading,D-D levels,and GCS scores.The model based on these three indicators has certain appli-cation value in predicting patient prognosis.关键词
头颅/CT环池分级/D-二聚体/预测/格拉斯哥昏迷量表/重型颅脑损伤/近期预后/影响因素Key words
cranial/CT cisternal grading/D-dimer/prediction/Glasgow Coma Scale/se-vere traumatic brain injury/short-term prognosis/influencing factors分类
临床医学引用本文复制引用
张列祥,何裕超,蔡畅,付宪华,李猛,徐进,姜宁,王协锋,陈宏璘..头颅CT环池分级、D-二聚体及格拉斯哥昏迷量表评分对重型颅脑损伤患者术后近期预后的预测价值[J].实用临床医药杂志,2025,29(8):17-21,5.基金项目
江苏省重点实验室开放课题资助项目(XZSYSKF2021044) （XZSYSKF2021044）
