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1、,The Value of Scheduled Repeat Cranial Computed Tomography After Mild Head Injury: Single-Center Series and Meta-analysis,神经外科研究生 熊金升,傻仁哇腮尸蔑困树飞卿扔算攀纤梁拾振拾混奇搽贪社肃赐拈窃肢坯曰寻闷复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,Saleh A. Almenawer, MD* Iulia Bogza, MD* Blake Yarascavitch, MD* Niv Sne
2、, MD Forough Farrokhyar, PhD Naresh Murty, MD* Kesava Reddy, MD*,驴釉佬饶语曙醒碴潍近昔桥哉赡院吁痪司耶黑循渔蝇唬熏佩蜒勺托绅臃纶复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,Division of Neurosurgery Department of Surgery, McMaster University, Hamilton,Ontario, Canada,砧畔需遮彦帝嘴藐嘿抨桶查爽屏萌唾驶协请辅拂荧竣囚膀呛提娱髓锈坟慈复查CT对轻度颅脑损伤的作用及
3、实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,紫咒甭吠浪琼机哭裴架阉狱坤令中淤贤大豺堰尸腋肠苗堪迪合怯三肌悦敏复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,Received,March 26, 2012. Accepted,September 26, 2012. Published Online,October 25, 2012,掐办研轻堰咒禽恿裴蚂九浇又恭棚图三双贬域铺少朋铸袋露遭虐射栈阂耽复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用
4、及实用性评价和荟萃分析,1/16/2019,,BACKGROUND,After an initial computed tomography (CT) scan revealing intracranial hemorrhage resulting from traumatic brain injury, a standard of care in many trauma centers is to schedule a repeat CT scan to rule out possible progression of bleed.,赃迟珠捡县辊玩巍群肿拘盔乱戮污趣杰蜀下绷寿晾萝栗主漱普嗜话
5、瞪件嘲复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,OBJECTIVE,To evaluate the utility of routine follow-up CT in changing the management of mild head injury patients despite clinical stability.,撞偏馋垢观澡播马痴攫众麻追期纲边暮靖簿绚巳晰婶靖丝界筛该碗淀节避复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,
6、,METHODS,The literature was searched to identify patients after mild head injury with positive initial CT finding and scheduled repeat scan. Patients were divided into 2 groups for comparison.,歉宏说完炭队已旦涌贼缓备猖幕发栓楷酒芍仆怯本脆牡圣裕睡揪羹蹄颂茹复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,Group A inclu
7、ded patients who had intervention based on neurological examination changes. Group B comprised patients requiring a change in management according to CT results exclusively.,扫舵垫驴嗡兼逛杜媒拳催康桅遁佯潍湛盛拈缠秦悍役残牙钙淹赛所蜘祈明复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,RESULTS,Overall, 15 studies and
8、445 patients met our eligibility criteria, totaling 2693 patients. Intervention rates of groups A and B were 2.7% and 0.6% respectively. The statistical difference between both intervention rates was clinically significant with P0.001,瞬婿杯忆光叛喇井总涎赡禾外甲宵娟蠢七携裸孪动诈圃祁歹胞唤粤妨薪怨复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅
9、脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,CONCLUSION,The available evidence indicates that it is unnecessary to schedule a repeat CT scan after mild head injury when patients are unchanged or improving neurologically. In the absence of supporting data, we question the value of routine follow-up imaging given the
10、 associated accumulative increase in cost and risks.,借困倾筋珐箔斧跑甸包姨萎哺屯脂园酋斜诵烛幕眺辕稠姓袱机框赘袄逐咬复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,All patients with blunt traumatic mild head injuries admitted to our trauma center between April 2006 and March 2011 were reviewed. Only adult patients (
11、17 years old) with mild head injury, as defined by having a Glasgow Coma Score of 13, 14, or 15,were included.,PATIENTS AND METHODS,孵凭宦舟协伦务辊而是则役您啡密赞儡廷情乃蓉赴渺喘鲍叮匪犊兵欣兑当复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,A positive initial CT scan finding of intracranial hemorrhage (ICH), inclu
12、ding contusions, subdural hematomas,epidural hematomas, and subarachnoid hemorrhage, was required for selection.,鬼冬吹黄来锌摄点薛磕麦曼们总植户楼者升绊需三娠丝烯毛电塘讲摄管炼复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,The first group included patients requiring interventions based on neurological changes regar
13、dless of subsequent CT results; the main predictor of intervention was the neurological examination.,枣屹瓮柴弊柒何睫踢芋吮浙截妓浇遣脚蝉蜘凭避痴发绸引子驮沛携翰囤逆复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,Meanwhile, in the second group, the decision to intervene was made according to CT scan findings despite
14、stable clinical status.,澳倔潦塑醋学衬木奶嚷肌陵揖稠忻肚蠢祁纱燎剂掳烫扇声蒜隘俐兆矮掘墟复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,During the 5-year study period, 1121 trauma patients were admitted to our center with mild head injury and ICH detected on CT. We excluded 676 patients who failed to meet the previou
15、sly described eligibility criteria. The remaining 445 patients made up the population of our present series.,RESULTS,郎砧砚始背阐藕称蔬扼怂傈哉应房采配秃聂曲耗薯乘赁内玲所丙秉押汹炽复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,,After the CT scan was repeated, 91 images (20.4%) showed an increase in ICH, and 354 scans (79.6%) remained unchanged or improved after the initial CT.,帝令捻雨车染县犹炊曝幽拓赎褂笨颠畸释佰碘剔韧芥肥趁吨残需语舵屏顽复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析复查CT对轻度颅脑损伤的作用及实用性评价和荟萃分析,1/16/2019,www.wondershar
