移动CT在重症患者风险管控中的临床应用价值  

Clinical application value of mobile CT in risk management and control of critically ill patients

作　　者：蒲进[1] 朱晏麟 夏春潮[1] 李真林[1] PU Jin;ZHU Yanlin;XIA Chunchao;LI Zhenlin(Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China;West China Clinical Medical College,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院放射科,四川成都610041 [2]四川大学华西临床医学院,四川成都610041

出　　处：《西部医学》2024年第8期1233-1236,1241,共5页Medical Journal of West China

基　　金：国家重点基础研究发展计划项目(2022YFC2009905-4)。

摘　　要：目的探讨重症监护室(ICU)患者行移动CT头部扫描的时效性、经济性、辐射剂量及临床价值。方法回顾性收集2022年9—12月我院临床怀疑进展性颅内出血需移动CT头部检查的ICU患者40例(移动CT组),因移动式CT维修需要转运至放射科CT室行头部检查的ICU患者40例(常规CT组)。记录两组患者完成检查的绝对风险时间、辐射剂量及检查流程,并由2位高年资影像医师对两组患者出血区的图像质量进行评分评价,并对结果进行统计学分析。结果移动CT组完成检查的平均绝对风险时间为(9.21±2.13)min,显著低于常规CT组的(47.43±7.10)min,差异有统计学意义(Z=30.542,P<0.05);移动CT组的容积CT剂量指数为(41.26±0.00)mGy·cm、剂量长度乘积为(660.16±0.00)mGy·mA^(-1)·s^(-1)以及有效辐射剂量为(1.52±0.00)mSv,均低于常规CT组的(55.41±10.75)mGy·cm、(824.88±174.63)mGy·mA^(-1)·s^(-1)、(1.90±0.40)mSv,差异有统计学意义(Z=49.543,P<0.05;Z=164.002,P<0.05;Z=9.500,P<0.05)。两组出血区的图像质量比较差异无统计学意义(Z=0.028,P>0.05)。移动CT组检查流程较常规CT组减少3个环节和3位医务人员。结论重症监护患者行CT头部扫描时,移动CT检查具有更高的时效性、降低了风险,节约了人力成本、降低了辐射剂量,能更好地服务于ICU需行头部CT检查的患者。Objective To investigate the timeliness,economy,radiation dose and clinical value of mobile CT head scanning in intensive care patients.Methods Eighty ICU patients clinically suspected of progressive intracranial hemorrhage from September to December 2022 were retrospectively collected,including 40 patients in mobile CT group and 40 patients in conventional CT group.The absolute risk time,radiation dose and examination procedure of the two groups were recorded.The image quality of the bleeding area was evaluated by two senior radiologists,and the results were analyzed statistically.Results The mean absolute risk time of the mobile CT group was(9.21±2.13)min,significantly lower than that of the conventional CT group(47.43±7.10)min(Z=30.542,P<0.05).The volumetric CT dose index(41.26±0.00)mGy·cm,dose-length product(660.16±0.00)mGy·mA^(-1)·s^(-1) and effective radiation dose(1.52±0.00)mSv in mobile CT group were lower than those in conventional CT group(55.41±10.75)mGy·cm,(824.88±174.63)mGy·mA^(-1)·s^(-1) and(1.90±0.40)mSv,with statistical significance(Z=49.543,P<0.05).Z=164.002,P<0.05;Z=9.500,P<0.05).There was no significant difference in image quality of bleeding area between the two groups(Z=0.028,P>0.05).The examination procedure of mobile CT group was reduced by 3 links and 3 medical staff compared with conventional CT group.Conclusion When intensive care patients undergo CT head scanning,mobile CT examination has higher timeliness,reduces risk,saves labor cost,reduces radiation dose,and can better serve patients in ICU who need to undergo head CT examination.

关 键 词：移动CT 重症监护 颅内出血 风险管控 

分 类 号：R445.3[医药卫生—影像医学与核医学]