头颅移动CT在NICU的临床应用价值  

Clinical value of portable head CT to patients in neurosurgery intensive care unit

作　　者：曹俊[1] 马延斌[1] 毛青[1] 王杨[1] 刘钰[1] 马蓉[1] 

机构地区：[1]上海交通大学医学院附属仁济医院神经外科,上海200127

出　　处：《中国临床神经外科杂志》2015年第9期532-534,537,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨头颅移动CT在神经外科重症监护室(NICU)的应用价值。方法我院2013年11月至2014年5月收治入住NICU病人388例,其中颅脑损伤75例,脑肿瘤155例,脑血管病119例,其他39例;共完成1 000例次头颅移动CT扫描。结果从患者离开床位接受CT扫描至回到原先床位并妥善连接监测和支持设备所需的时间为(8.0±2.5)min,实际CT扫描所需时间为(2.5±0.6)min。200例接受1次移动CT扫描,87例接受2次移动CT扫描,34例接受3次移动CT扫描,67例接受3次以上的移动CT扫描,12例超过10次以上的移动CT扫描。每例患者在NICU接受CT扫描检查平均2.57次。移动CT影像学发现:一般术后改变共420例次,颅内出血共170例次,脑梗死共98例次,脑积水共84例次,脑水肿共106例次,颅内占位共95例次,其他发现共27例次。473例次(47.3%)显示阳性影像学发现(指需要立即干预的颅内病变如肿瘤残余、术区出血、迟发血肿、急性脑积水和脑肿胀等)。没有一个病人因移动CT图像质量问题而被重新送到放射科CT室行CT检查。结论移动CT可为NICU患者提供及时可靠的影像学诊断,为临床干预提供强有力依据,操作便捷,使用安全。Objectives To explore the use of the portable head CT in neurosurgery intensive care unit （NICU） and its clinical value. Methods According to the history and nursing records and imaging data saved in the portable CT workstation, the data of 1 000 consecutive portable head CT scans performed in 388 patients in our hospital＇s NICU were analyzed. Main research contents included clinical diagnosis, the cause and the number of the CT scans, the result of CT scans, the levels of patients＇ consciousness on scanning, the patients＂ respiratory condition （intubation or artificial respiration）, the pipeline which patients carried, the CT scanning time, the time when patients were out of the monitoring and the breathing machine, use of sedatives and so on. Results Of 388 patients [mean age, （53R445.3 18） years] receiving a total of 1 000 portable CT scans, 75 suffered from craniocerebral trauma, 155 from brain tumors, 119 from cerebrovascular disease （including spontaneous cerebral hemorrhage, cerebral infarction and subarachnoid hemorrhage） and 39 from other cerebral disease. Of 473 （47.3%） the portable CT scans showing the positive findings, 27 （5.7%） directed surgical treatment and 446 （94.3%） the dehydration and ventricular drainage of cerebrospinal fluid. In this study, the patients with unconsciousness （GCS~〈 12） received 439 CT scans （43.9%）, ones with endotracheal intubation or tracheostomy 227 （22~7%）, ones with artificial breathing 68 （6.8%） and ones treated by the calmative 132 （13.2%）. There averagely were 4.2 pipelines （including ventilation, infusion, drainage, monitoring, urethral catheterization, etc.） per a scanning in every patient. There was not accidental disconnection of the pipelines from the patients during scanning. The average total time to perform a portable head CT scan was （8.0±2.5）min. The actual scan time was （2.5±0.6）min. Conclusion Portable CT can provide reliable imaging diagnosis in time for the critically ill patients in

关 键 词：神经重症 神经外科重症监护室 移动CT 应用价值 

分 类 号：R651[医药卫生—外科学] R445.3[医药卫生—临床医学]