| 王衍刚,吕振普,郑献召,秦政,李建新,葛冉,赵菲菲.颅脑超声用于急性重型颅脑创伤围手术期[J].中国医学影像技术,2024,40(8):1156~1159 |
| 颅脑超声用于急性重型颅脑创伤围手术期 |
| Cranial ultrasound in perioperative period of acute severe traumatic brain injury |
| 投稿时间：2023-11-12 修订日期：2024-05-14 |
| DOI：10.13929/j.issn.1003-3289.2024.08.008 |
| 中文关键词: 颅脑损伤 围手术期 超声检查 |
| 英文关键词:craniocerebral trauma perioperative period ultrasonography |
| 基金项目:河南省医学科技攻关计划联合共建项目(LHGJ20191341)。 |
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| 中文摘要: |
| 目的 探讨颅脑超声在急性重型颅脑创伤(sTBI)围手术期的应用价值。方法 回顾性分析55例接受开颅手术的sTBI患者,根据围手术期接受床旁颅脑超声与否将其纳入观察组(n=15)与对照组(n=40);比较组间一般资料及手术资料,分析观察组超声表现。结果 [JP2]观察组术后1及6个月预后良好者占比高于、脑梗死发生率低于对照组(P均＜0.05);组间一般资料及其余手术资料差异均无统计学意义(P均＞0.05)。观察组1例术中发生急性脑膨出,颅脑超声准确显示对侧继发硬膜外血肿。术后经颅彩色多普勒超声(TCCD)/经颅多普勒超声(TCD)显示,观察组15例(15/15,100%)均出现不同程度颅内压增高、5例(5/15,33.33%)出现脑血管痉挛,通过复查CT将其中4例(4/5,80.00%)诊断为脑梗死。结论 颅脑超声可观察sTBI围手术期病情变化、指导及时调整诊疗策略,有助于降低术后脑梗死风险及改善预后。 |
| 英文摘要: |
| Objective To observe the value of cranial ultrasound for perioperative patients with acute severe traumatic brain injury (sTBI). Methods Data of 55 sTBI patients who underwent craniotomy were retrospectively analyzed. The patients were divided into observation group (n=15) and control group (n=40) according to received perioperative cranial ultrasound or not. The general data and surgical data were compared between groups, and ultrasonic data of observation group were analyzed. Results The proportions of good prognosis 1 and 6 months after operation in observation group were both higher than those in control group, while the incidence of cerebral infarction in observation group was lower than that in control group (all P＜0.05). No significant difference of general data nor other surgical data was found between groups (all P＞0.05). Acute encephalocele occurred in 1 case in observation group during operation, and cranial ultrasound accurately showed the contralateral secondary epidural hematoma. Increased intracranial pressure in different degrees were found in all 15 cases (15/15, 100%) in observation group after operation with transcranial color coded Doppler (TCCD) or transcranial Doppler (TCD), while cerebral vascular spasm was observed in 5 cases (5/15, 33.33%), among them 4 cases (4/5, 80.00%) were diagnosed cerebral infarction based on CT examination. Conclusion Cranial ultrasound could be used to evaluate changes of sTBI in perioperative period and guide adjusting treatment strategy in time, being valuable for reducing risk of postoperative cerebral infarction and improving prognosis. |
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