目的：探讨颅脑 CT 漩涡征对创伤性硬膜外血肿患者血肿扩大的评估价值。方法选取2013年1月—2014年5月南华大学附属第一医院收治的急性创伤性硬膜外血肿患者64例，根据颅脑 CT 有无漩涡征分为：阳性组31例，阴性组33例。分析颅脑 CT 漩涡征对预测血肿扩大的正确率、灵敏度、特异度、阳性似然比、阴性似然比。应用多元 Logistic 回归分析血肿扩大发生的影响因素。结果阳性组血肿扩大率为83.9％（26/31），阴性组血肿扩大率为51.5％（17/33），差异有统计学意义（χ2＝7.590，P ＝0.006）。颅脑 CT 漩涡征预测血肿扩大正确率为67.2％（43/64）、灵敏度为60.5％（26/43）、特异度为76.2％（16/21）、阳性似然比为2.54、阴性似然比为0.52。多元 Logistic回归分析结果显示，漩涡征与创伤性硬膜外血肿患者血肿扩大有回归关系（P ＝0.009）。结论颅脑 CT 漩涡征对创伤性硬膜外血肿患者血肿扩大具有较好的预测价值，临床意义较高。%Objective To analyze the value of cranial CT swirl sign in evaluation of hematoma enlargement in patients with traumatic epidural hematomas( TEH). Methods 64 patients with acute THE who were treated in the First Hospital Affiliated to University of South China during January 2013 to May 2014,were divided into positive group(31 cases,with cranial CT swirl sign)and negative group(33 cases,without cranial CT swirl sign)according to the existence of swirl sign by cranial CT. The accuracy rate,sensitivity,specificity,positive likelihood ratio and negative likelihood ratio of cranial CT swirl sign in prediction of hematoma enlargement were analyzed. The multivariate Logistic analysis was performed to analyse the influence factors for hematoma enlargement. Results The prevalence of hematoma enlargement in positive group〔83. 9% (26/ 31)〕was significantly higher than that〔51. 5% (17 / 33)〕in negative group(χ2 = 7. 590,P = 0. 006). The accuracy rate, sensitivity,specificity,positive likelihood ratio and negative likelihood ratio of cranial CT swirl sign in prediction of hematoma enlargement was 67. 2% ( 43 / 64 ),60. 5% ( 26 / 43 ),76. 2% ( 16 / 21 ),2. 54 and 0. 52, respectively. According to multivariant Logistic analysis results,there was a linear regression relationship between cranial CT swirl sign and hematoma enlargement in patients with TEH(P = 0. 009). Conclusion The cranial CT swirl sign can predict the hematoma enlargement in patients with THE well,so it has an important clinical value.
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