床旁超声实时引导手术对重型颅脑损伤患者急性脑膨出的影响  

Effect of bedside surgery with real-time guidance of ultrasound on acute encephalocele of patients with severe craniocerebral injury

作　　者：周恒[1] 王俊玲[1] 张志洁[1] ZHOU Heng;WANG Jun-ling;ZHANG Zhi-jie(Department of Ultrasound Medicine,Dezhou People’s Hospital,Dezhou 253014,China;不详)

机构地区：[1]德州市人民医院超声医学科,山东德州253014

出　　处：《中国医学装备》2023年第3期89-93,共5页China Medical Equipment

摘　　要：目的:探讨床旁超声实时引导手术对重型颅脑损伤患者急性脑膨出的影响,以期指导重型颅脑损伤治疗方案的优化。方法:选取在医院接受手术治疗的80例重型颅脑损伤患者,依据随机数表法将其分为对照组和观察组,每组40例。两组术前均接受电子计算机断层扫描(CT)检查,对照组术中采用常规方法监测急性脑膨出的风险,观察组采用床旁超声实时引导监测急性脑膨出的风险;对比分析两组手术相关指标,迟发型血肿、弥漫性脑肿胀检出情况及急性脑膨出发生情况;记录术后中线移位距离和侧脑室宽度;采用格拉斯哥昏迷指数(GCS)评估术后7 d预后情况;随访15 d,对比两组并发症及病死情况。结果:观察组手术时间短于对照组,术中失血量少于对照组,治疗费用低于对照组,两组比较差异有统计学意义(t=2.800,t=3.146,t=2.462;P<0.05);观察组迟发性血肿、弥漫性脑肿胀检出率均高于对照组,急性脑膨出发生率低于对照组,两组比较差异有统计学意义(χ^(2)=5.952,χ^(2)=5.591,χ^(2)=5.165;P<0.05);两组术后中线移位距离和侧脑室宽度比较差异无统计学意义;观察组整体预后情况优于对照组,两组术后并发症发生率比较差异无统计学意义;观察组病死率低于对照组,两组比较差异有统计学意义(χ^(2)=4.507,P<0.05)。结论:床旁超声实时引导手术可提高迟发型血肿和弥漫性脑肿胀检出率,指导干预可减少急性脑膨出发生,患者病死率降低、预后得到改善。Objective:To investigate the effect of bedside surgery with real-time guidance of ultrasound on acute encephalocele of patients with severe craniocerebral injury,in order to guide the optimization of the treatment plan for severe craniocerebral injury in the future.Methods:A total of 80 patients with severe craniocerebral injury who underwent surgery in hospital were selected and they were divided into a control group and an observation group according to the random number table,with 40 cases in each group.Both groups underwent computed tomography(CT)examinations before operation,and the control group adopted routine monitoring for the risk of acute encephalocele during the operation,and the observation group adopted real-time guidance of bedside ultrasound.The operationrelated indicators were recorded,as well as the detections of delayed hematoma and diffuse brain swelling,and the occurrence of acute encephalocele.In addition,the displacement distance of postoperative midline and the width of lateral ventricle also were recorded.The prognosis of 7 days after surgery was assessed by using glasgow coma score(GCS),and the follow-up was 15 days,and the conditions of the complications and death were recorded.Results:The operation time,the blood loss volume during the operation and the therapeutic cost of observation group were significantly shorter,less and lower than those of control group(t=2.800,t=3.146,t=2.462,P<0.05),respectively.The detection rates of delayed hematoma and diffuse brain swelling in observation group were significantly higher than those in control group,and the incidence of acute encephalocele of former was significantly lower than that of control group(χ^(2)=5.952,χ^(2)=5.591,χ^(2)=5.165,P<0.05),respectively.There were no significant difference in the displacement distance of postoperative midline and the width of lateral ventricle between two groups,and the entire prognosis of observation group was better than that of control group,and the incidence of postoperative complications between the

关 键 词：重型颅脑损伤 手术 床旁超声 实时引导 急性脑膨出 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学]