摘要：

目的: 探究闭合性颅脑创伤患者头部脑组织移位程度CT参数与颅内压水平的相关性。方法: 选择2018年1月至2021年3月重庆市开州区人民医院收治的84例单侧闭合性颅脑创伤患者，均行头部CT检查并测量中线两侧CT值、中线两侧CT值比值和中线移位距离；Pearson相关分析和偏相关分析探究闭合性颅脑创伤患者头部CT参数与颅内压的相关性；绘制受试者工作特征（ROC）曲线，评价CT参数对颅内压升高的预测效能。结果: 相关分析显示，中线两侧CT值比值（r = 0.478，P = 0.000）和中线移位距离（r = 0.378，P = 0.000）与颅内压呈正相关。ROC曲线显示，中线两侧CT值比值、中线移位距离及二者联合预测颅内压升高的曲线下面积为0.79（95%CI：0.687 ~ 0.889，P = 0.000）、0.89（95%CI：0.794 ~ 0.943，P = 0.000）、0.91（95%CI：0.845 ~ 0.970，P = 0.000），灵敏度和特异度分别为80.95% 和73.81%、69.05% 和90.48%、80.95% 和85.71%，其中二者联合指标的预测效能优于中线两侧CT值比值（t = - 2.964，P = 0.003）。结论: 单侧闭合性颅脑创伤患者脑组织移位程度CT参数与颅内压水平密切相关，联合中线两侧CT值比值和中线移位距离预测颅脑创伤后颅内压升高的效能较高。

关键词: 脑损伤, 创伤性, 体层摄影术, 螺旋计算机, 颅内压, ROC曲线

Abstract:

Objective: To investigate the relationship between the CT parameters of degree of brain tissue displacement and intracranial pressure (ICP) in patients with closed traumatic brain injury (TBI). Methods: A total of 84 patients with closed TBI were chosen from January 2018 to March 2021 in The People's Hospital of Kaizhou District. Head CT examination was performed and CT values on both sides of the midline, the ratio of CT values on both sides of the midline and the midline shift distance were measured. Pearson and partial correlation analyses were used to investigate the correlation between head CT parameters and ICP in patients with closed TBI. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of CT parameters in increased ICP. Results: Correlation analysis showed that the ratio of CT values on both sides of the midline (r = 0.478, P = 0.000) and midline shift distance (r = 0.378, P = 0.000) were positively correlated with ICP. ROC curve showed that the ratio of CT values on both sides of the midline, the midline shift distance and the combined index prediction of ICP were 0.79 (95%CI: 0.687-0.889, P = 0.000), 0.89 (95%CI: 0.794-0.943, P = 0.000) and 0.91 (95%CI: 0.845-0.970, P = 0.000), the sensitivity and specificity were 80.95% and 73.81%, 69.05% and 90.48%, 80.95% and 85.71%, and the prediction efficiency of the combined index was better than the ratio of CT values on both sides of the midline (t =-2.964, P = 0.003). Conclusions: The CT parameters of brain tissue displacement degree in patients with unilateral closed TBI are closely related to the ICP, and the combination of the ratio of CT values on both sides of the midline and midline shift distance can predict ICP increase more effectively.

Key words: Brain injuries, traumatic, Tomography, spiral computed, Intracranial pressure, ROC curve