NEXUS 头部 CT 决策工具
用途适用： adults with blunt head trauma within ~24 h in whom CT is being considered.
分层Low-risk supports deferred CT with return precautions; any criterion supports imaging.
局限不适用： penetrating injury, unreliable exam, or when Canadian CT Head Ru… · 易错点： calling facial-only hematoma a scalp hematoma incorrectly — foll… · High-energy mechanism still warrants clinical judgment.
出处Mower WR, et al. PLoS Med 2017 (NEXUS Head CT DI validation)
本班次下一步
评完分数后：进场景连算、看相邻评分、打开对应路径。本地参考，不写入 HIS。
方法学 · 公式代入、指南要点与完整说明
适用场景
适用： adults with blunt head trauma within ~24 h in whom CT is being considered.
需要填写的项目
- Age ≥ 65 years · 选项
- Evidence of significant skull fracture · 选项
- Scalp hematoma · 选项
- Neurologic deficit · 选项
- Altered level of alertness · 选项
- Abnormal behavior · 选项
- Coagulopathy · 选项
- Persistent / recurrent vomiting (>1 episode) · 选项
计算方法与公式
Low-risk only if ALL absent: age≥65, significant skull fracture signs, scalp hematoma, neurologic deficit, altered alertness, abnormal behavior, coagulopathy, persistent vomiting.
Document each criterion; any yes or any unassessed item → not low-risk.
公式代入演示
下列数值取自本工具各输入项的示例值，用本页公式在服务端实际算出，供快速核对计算过程。仅演示代入方法，不构成临床建议，也不代表任何真实病例。
| Age ≥ 65 years | 否 |
|---|---|
| Evidence of significant skull fracture | 否 |
| Scalp hematoma | 否 |
| Neurologic deficit | 否 |
| Altered level of alertness | 否 |
| Abnormal behavior | 否 |
| Coagulopathy | 否 |
| Persistent / recurrent vomiting (>1 episode) | 否 |
→NEXUS HeadLow-risk — CT may be deferred
- Positive criteria：None
- Rule：Low-risk only if ALL eight absent
| Age ≥ 65 years | 是 |
|---|---|
| Evidence of significant skull fracture | 是 |
| Scalp hematoma | 是 |
| Neurologic deficit | 是 |
| Altered level of alertness | 是 |
| Abnormal behavior | 是 |
| Coagulopathy | 是 |
| Persistent / recurrent vomiting (>1 episode) | 是 |
→NEXUS HeadNot low-risk — CT indicated
- Positive criteria：8
- Rule：Low-risk only if ALL eight absent
结果判读与分层
Low-risk supports deferred CT with return precautions; any criterion supports imaging.
指南要点（原创整理）
- Eight binary criteria.
- Any positive → CT.
- 下一步： Canadian CT Head Rule / PECARN (peds) as locally indicated.
以上为依据相应指南的关键推荐、由本站用自己的语言归纳整理（非指南原文）；完整内容请见下方官方来源。
注意事项与局限
- 不适用： penetrating injury, unreliable exam, or when Canadian CT Head Rule is the mandated local pathway without dual application training.
- 易错点： calling facial-only hematoma a scalp hematoma incorrectly — follow NEXUS definitions.
- High-energy mechanism still warrants clinical judgment.
核对与出处 · 可验证治理
参考指南与出处
- Mower WR, et al. PLoS Med 2017 (NEXUS Head CT DI validation) · 来源 ↗
- Mower WR, et al. J Trauma 2005 (derivation)
指南全文版权归相应学会/期刊所有；本工具仅实现其决策算法并注明出处，全文请经上方官方来源获取。
依据文献年份见参考 · 数据集整理日 2026-10-08
常见问题
常见问题
- NEXUS 头部 CT 决策工具的计算是否上传患者数据？在哪里计算？
- 计算在浏览器本地完成，输入与结果不上传服务器；结果仅供执业医师参考，须结合病史、检查与本机构方案判断，不构成诊断或处方依据。
- NEXUS 头部 CT 决策工具怎么代入计算？能举个例子吗？
- 代入: Age ≥ 65 years 否、Evidence of significant skull fracture 否、Scalp hematoma 否、Neurologic deficit 否、Altered level of alertness 否、Abnormal behavior 否、Coagulopathy 否、Persistent / recurrent vomiting (>1 episode) 否 → 结果: NEXUS Head Low-risk — CT may be deferred（Positive criteria: None、Rule: Low-risk only if ALL eight absent） 代入: Age ≥ 65 years 是、Evidence of significant skull fracture 是、Scalp hematoma 是、Neurologic deficit 是、Altered level of alertness 是、Abnormal behavior 是、Coagulopathy 是、Persistent / recurrent vomiting (>1 episode) 是 → 结果: NEXUS Head Not low-risk — CT indicated（Positive criteria: 8、Rule: Low-risk only if ALL eight absent）
核对流程与方法学
核对与依据
本工具的公式与计算方法已在本页明示、公开可逐一核查。其公式、系数与阈值依据上方「参考指南与出处」列出的权威来源核对。想了解本站对全部临床工具的核对流程与出处覆盖情况，见 临床工具核对表与方法学 →