颅脑超声检查对去颅骨骨瓣减压术后颅内情况的评估作用  

Evaluation effect of craniocerebral ultrasonography on intracranial condition after decompressive craniectomy

作　　者：高春雷 史占华 赵鸿玲[4] 孙志刚 张二成[6] 康旭晖 王娉 GAO Chunlei;SHI Zhanhua;ZHAO Hongling;SUN Zhigang;ZHANG Ercheng;KANG Xuhui;WANG Ping(Graduate School of Medicine,Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040,China;Department of Neurosurgery,Baotou Central Hospital;Department of Neurosurgery,Baotou Eighth Hospital;Department of Ultrasonography,Sinpharm North Hospital;Baotou Municipal Commission of Health;Department of Emergency Medicine,Baotou Central Hospital)

机构地区：[1]内蒙古科技大学包头医学院研究生院,内蒙古包头014040 [2]包头市中心医院神经外科 [3]包头市第八医院神经外科 [4]国药北方医院超声科 [5]包头市卫生健康委员会 [6]包头市中心医院急诊医学科

出　　处：《包头医学院学报》2023年第12期45-49,共5页Journal of Baotou Medical College

基　　金：包头市科技计划项目(2020Z1013-1)。

摘　　要：目的:通过颅脑超声和CT的检查结果比较,探讨颅脑超声检查对去颅骨骨瓣减压术后重症患者颅内情况的评估作用。方法:选取2020年12月至2021年11月来自包头市中心医院和包头市第八医院因脑出血、脑外伤、脑梗死接受去颅骨骨瓣减压术的患者50例作为研究对象。同时进行经骨窗床旁颅脑超声检查和CT检查,诊断去颅骨骨瓣减压术后并发症,收集术后常见的脑中线结构移位、颅内出血、脑室改变、硬膜下积液、脑组织水肿等相关数据,分析两种检查结果的差异性。结果:所选择研究50例患者共出现并发症30例,颅脑超声检出25例,漏诊5例,检出率83.33%;CT检查检出30例,检出率100%;经卡方检验P>0.05,提示两种检查方法检出率不存在较明显差异。颅脑超声对于脑中线结构移位、颅内出血、脑室改变、硬膜下积液的总检出率要低于CT,但差异不大(P>0.05)。CT和颅脑超声对脑中线结构移位距离、颅内出血中脑室出血检出率、实质出血检出率、脑室改变情况、硬膜下积液检出率结果比较,P>0.05,无统计学意义。颅脑超声和CT测量脑中线移位的移位距离、血肿大小的各项参数测量结果显示,P>0.05,差异不显著。血肿体积进行Bland-Altman一致性分析,结果显示P>0.05,差异不显著,提示颅脑超声测量血肿体积与CT测量的血肿体积存在较好的一致性。结论:颅脑超声检查能够有效地对去骨瓣减压术后患者进行颅内影像学评估,有效诊断术后并发症,检查结果与头颅CT具有良好一致性,值得临床推广。Objective:To explore the evaluation effect of craniocerebral ultrasound on intracranial condition of severe patients after decompressive craniectomy by the results of craniocerebral ultrasound and CT.Methods:From December 2020 to November 2021,50 patients who underwent decompressive craniectomy for cerebral hemorrhage,cerebral trauma and cerebral infarction from Baotou Central Hospital and Baotou Eighth Hospital were selected as subjects.At the same time,the bedside craniocerebral ultrasound examination and CT examination were performed to diagnose the complications after decompressive craniectomy.The common data of brain midline structure displacement,intracranial hemorrhage,ventricular changes,subdural effusion and brain tissue edema were collected,and the differences between the two examination results were analyzed.Results:Among the 50 patients,30 patients had complications,while 25 patients were detected by craniocerebral ultrasound,5 patients were missed,and the detection rate was 83.33%;30 patients were detected by CT examination,the detection rate was 100%;the chi-square test P>0.05,suggesting that there was no significant difference in the detection rate between the two methods.The total detection rate of craniocerebral ultrasound for midline structure displacement,intracranial hemorrhage,ventricular changes,and subdural effusion was lower than that of CT,but the difference was not statistically significant(P>0.05).There was no significant difference between CT and craniocerebral ultrasound in the displacement distance of brain midline structure,the detection rate of ventricular hemorrhage in intracranial hemorrhage,the detection rate of parenchymal hemorrhage,the change of ventricle and the detection rate of subdural effusion(P>0.05).There was no significant difference in the displacement distance of brain midline structure and the size of hematoma measured by craniocerebral ultrasound and CT(P>0.05).The hematoma volume was analyzed by Bland-Altman consistency analysis,and the results showed that the di

关 键 词：去骨瓣减压术 颅脑超声 颅内压 颅脑损伤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R651.1[医药卫生—诊断学]