重症监护患者床旁移动CT与常规CT头部扫描结果对比分析  

Comparative analysis of head scan results of bedside mobile CT and conventional CT in intensive care patients

作　　者：郑全乐 陈文锦 吴国华 李春虎 张家瑞 李学天 张同乐 周顺义 徐如祥 Zheng Quanle;Chen Wenjin;Wu Guohua;Li Chunhu;Zhang Jiarui;Li Xuetian;Zhang Tongle;Zhou Shunyi;Xu Ruxiang(Brain Center,Edberg Hospital,Langfang 065000,China;Department of Neurosurgery,the Seventh Medical Center,PLA General Hospital,Beijing 100700,China;Department of Neurosurgery,Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital,Chengdu 610072,China)

机构地区：[1]爱德堡医院脑科中心,廊坊065000 [2]解放军总医院第七医学中心神经外科,北京100700 [3]四川省医学科学院·四川省人民医院神经外科,成都610072

出　　处：《中华脑科疾病与康复杂志（电子版）》2021年第5期300-304,共5页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：全军十二五军事医学重点课题(BWS12J010);军队医药卫生成果扩试项目(20WKS08);国家自然科学基金青年科学基金(81100971)。

摘　　要：目的对比分析颅脑重症患者在重症监护(ICU)移动CT床旁头部扫描与放射科大型CT头部扫描结果。方法选择廊坊爱德堡医院自2017年12月至2019年11月于ICU应用国产16排移动CT实施头部扫描的患者27例为移动CT组,选择同期ICU转运到放射科进行64排大型CT头部扫描的重症患者30例为大型CT组。记录头部断层成像及不良事件发生率、CT检查耗时、人员累计时间及辐射剂量指标等。结果成像质量及不良事件:移动CT组和大型CT组均成像清晰,诊断准确脑出血、脑梗死、脑损伤等;移动CT组未发生不良事件,大型CT组不良事件发生率为23.33%。移动CT组平均耗时为(15.68±2.69)min,而大型CT组平均耗时为(27.47±4.38)min,2组检查耗时、人员累计时间差异具有统计学意义(P<0.001)。辐射风险性:移动CT组容积CT剂量指数为(34.55±4.08)mGy,剂量长度乘积为(370.93±69.15)mGy.cm,有效剂量为(0.80±0.06)mSv,大型CT组分别为(56.49±7.42)mGy、(902.59±128.18)mGy.cm、(1.90±0.27)mSv,2组各项辐射指标差异均具有统计学意义(P<0.05)。结论移动CT组与大型CT组头部扫描成像质量均符合临床诊断标准,移动CT组无不良事件发生率,人员累计时间、检查耗时及辐射剂量均显著低于大型CT组。Objective To compare and analyze results of head scan,incidence of adverse events,time consuming,accumulated working hours and radiation risk of bedside mobile CT and conventional large-scale CT.Methods Twenty-seven patients who underwent head scanning with domestic 16 row mobile CT in ICU of Langfang Edberg Hospital from December 2017 to November 2019 were selected as mobile CT group,and 30 severe craniocerebral patients who were transferred from ICU to Radiology Department for 64 row large CT head scanning in the same period were selected as large CT group.The results of quality of head tomography and the incidence of adverse events were collected,and the scanning time consuming,personnel cost and radiation dose of CT examination were recorded respectively.Results Imaging quality and adverse events:The imaging were clear both mobie and convetional CT.Both CT showed clear and accurate diagnosis of cerebral hemorrhage,cerebral infarction and brain damage,et al.There was no adverse events in the mobile CT bedside scanning,while the incidence of adverse events in conventional large CT scanning was 23.33%.The average examination time of the mobile CT group was(15.68±2.69)min,while the conventional large CT group was(27.47±4.38)min.The statistical analysis showed a significant difference in examination times and personnel costs between the two groups(P<0.001).The radiation dose indicators of mobile CT group recorded of CT dose index volume(34.55±4.08)mGy,dose length product(370.93±69.15)mGy.cm,and effective dose(0.80±0.06)mSv;While in the conventional large CT group,the radiation dose indicators were(56.49±7.42)mGy,(902.59±128.18)mGy.cm,and(1.90±0.27)mSv respectively.There were significant differences in the radiation dose indicators between the two groups(P<0.05).Conclusion The quality of head scan imaging in both the mobile and the conventional large CT groups met the clinical diagnostic criteria.However,no adverse events occurred in the mobile CT group,and acuumulated working hours,examination time and rad

关 键 词：脑出血 脑损伤 移动CT CT床旁扫描 大型常规CT 

分 类 号：R459.7[医药卫生—急诊医学] R816.1[医药卫生—治疗学]