Computed Tomography of Head Trauma in Children

兒童頭部傷害的電腦斷層掃描

吳美倫(Mei-Lun Wang) ； 錢本文(Poon-Ung Chieng) ； 黃國茂(Kou-Mou Huang) ； 李瑤華(Yiu-Wah Li) ； 徐劍耀(Chien-Yao Hsu)

《中華放射線醫學雜誌》 15卷1期 (1990/03) Pp. 57-68

摘要

電腦斷層掃描對頭部外傷的評估提供最好的訊息。本文收集了台大醫院自1980年一月至1987年十月因頭部外傷來求診病例共4,752例。其中有1,002例為年齡自三個月至15歲孩童，佔全部之21.6%。包括628例男童及374例女童，男女童比例為1.68:1。摔傷為主要傷害原因，車禍次之。有一半發生於五歲以前，佔51.2%。六至十一歲學齡兒童佔36.23%，初中學童佔12.57%。總共有80例病童曾進行電腦斷層掃描檢查，佔兒童頭部傷害求診總數的7.98%。其中包括56例男童(70%)和24例女童(30%)。學齡前兒童群中，頭部傷害發生後，男童偏高的求診率（男童30.34%；女童20.85%）和偏低的電腦斷層掃描檢查需求率（男童6.25%；女童8.13%）可能由於家庭對男童的重視和對女童的疏於照顧。學齡兒童群中（包括小學及初中學童），男童偏高的求診率（男童23.85%及8.48/5；女童12.38%及4.09%）和偏高的電腦斷層掃描檢查需求率（男童12.13%及9.41%；女童4.84%及2.44%）顯示了學齡男童因具較大的活動性而發生較多、較嚴重的頭部傷害。電腦斷層掃描可早期診斷顱內或顱外的病灶，並可結合神經學的檢查對預後作評估。

並列摘要

Computed Tomography (CT) is by far the best means of evaluating head trauma. From January 1980 till October 1987, there were 4752 cases of head injuries being enrolled at National Taiwan University hospital (NTUH). One thousand and two (21.16%) cases of them were children from 3 months to 15 years old. There were 628 boys and 374 girls in a ratio of 1.68:1. Fall was the major cause of head injury and traffic accident accounted next in frequency. Half of these tragedies occurred before the age of 5, accounting for 51.2% of head jnjuries. The frequency of head jnjury was 36.23% in primary school of the age of 6 to 11, while junior high school students accounted for only 12.57%. Totally 80 children, (56 boys (70%) and 24 girls (30%), with an frequency of 7.98%, underwent CT scanning of head. When both the age and sex of the children were considered, subtle findings were disclosed: For preschool children the incidence of reported injury was 30.34% for boys and 20.85% fo girls, while the incidence of severe jnjury to require a CT study was only 6.25% for boys but 8.13% for girls. However, for school children, the boys had a higher percentage requiring head CT with 12.13% and 9.41% as compared to 4.84% and 2.44% of the girls from primary and junior high school. It is highly possible that the society still places a much higher emphasis on caring for boys than girls in both preventing injuries and seeking medical attention for injuries at preschool aged children. Obviously, energetic boys suffer more significant head injurries than the girls during the school age. The use of CT scanner has facilitated the early diagnosis of both extracranial and intracranial traumatic lesion. A CT scan correlated with the neurological examination may provide information reliably to predict outcome in children.

並列關鍵字

Trauma ； head ； children ； computed tomography CT