儿童轻型头部外伤 CT 检查临床决策规则及应用现状.pdfVIP

.718 . 中国小儿急救医学2015 年10月第22 卷第10期 Chin Pediatr Emerg Med,Oct 2015,Vol.22,No.10 .综述 . 儿童轻型头部外伤CT 检查临床决策规则及应用现状 张靖 丁华新 【摘 要】 脑外伤是儿童主要创伤性疾病和致死、致残原因,儿童头部外伤大约40% ~60%进行 了头部CT 检查,其中不 10%发生外伤性脑损伤。为减少儿童不必要的头部CT 检查,国外研究主要 有预测儿童头部损伤重要临床事件、儿科急救治疗应用研究网络和加拿大儿童头部外伤X 线检查评估 等临床决策规则,指导临床医生决策儿童轻型头部外伤后CT 的应用,现就目前临床应用的主要临床决 策规则进行综述。 【关键词】 儿童脑外伤；CT 检查；临床决策规则 Clinical decision rules for the application ofcomputed tomography in children with minor head injury Zhang Jing,Ding Huaxin.Emergency Department,Yangang Hospital of Yantian District,Shenzhen 518083 , China Corresponding author:Ding Huaxin(E-mail:dhxygyy@163.com) 【Abstract】 Pediatric head injury is the leading cause of death and disability,about 40% to 60% of kids of head injury get a CT,and the majority are those with minor head injury,about 10% of these CT scans are positive.Clinical decision rules for pediatric head injury exist to identify children at risk of traumatic brain injury.Those of the highest quality are children＇s head injury algorithm for the prediction of important clinical events(C ALICE),Pediatric Emergency Care Applied Research Network(PECARN)and the Canadian as- sessment of tomography for childhood head injury (CATC )clinical decision rules.This review aimed to systematically introduce primary clinical decision rules for children with minor head injury and compare them for diagnostic accuracy in detecting intracranial injury and injury requiring neurosurgery. 【Key words】 Pediatric head injury；CT scans；Clinical decision rules 脑外伤是儿童最主要创伤性疾病和致死、致 疗,保障患儿安全前提下减少盲目对患儿进行 CT 残的主要原因。目前儿童轻型头部外伤40% ~ 检查。该研究在10 家医院急诊科进行,对象为急 60%进行了头部CT 检查,其中不 10%发生外伤 诊轻型头部外伤儿童[格拉斯哥(glasgow coma 性脑损伤,需要神经外科治疗者