移动式床旁CT-CereTom在手术室中的应用

APPLICATIONS PORTABLE BEDSIDE CT-CERETOM IN THE OPERATING ROOM

目的了解移动式床旁CT(Portable Bedside CT,PBCT)-CereTom在神经外科手术中的临床应用及其价值。方法 2011年2月—2012年2月,对64例神经外科手术中患者进行床旁头颅CT扫描监测,其中高血压脑出血血肿清除术36例,外伤性脑出血血肿清除术28例。64例患者均使用PBCT-Cer-eTom在神经外科术前及术后行常规头颅CT扫描。监测血肿清除手术疗效。术前及术中头部CT扫描层厚5mm,扫描时间为50ms。PBCT及操作人员在进入手术室时需进行必要的消毒处理,PBCT进行紫外线照射20～30min,其支撑轮要经过消毒液消毒,操作人员需穿戴隔离衣帽口罩及鞋套。结果 64例术中头颅CT扫描,高血压性脑出血36例,其中基底节区血肿31例,小脑血肿5例;外伤性脑出血28例,其中大脑半球血肿12例,小脑血肿3例,硬膜外血肿5例,硬膜下血肿8例。本组64例患者颅内引流管的位置到位,手术后残留血肿仅有少量者为10例,全部消失者54例。PBCT-CereTom行术中头颅CT平扫每例平均为2min,术中检查平均20～30min(不含消毒时间),一次性成功率100%。在检查过程中,患者病情无加重或无其他意外发生。经PBCT-CereTom的手术中的头颅CT检查发现所有病例图像均符合CT诊断要求。结论 PBCT-CereTom在神经外科术中应用,不仅能够提供高质量的影像图像,而且能够即时监测手术疗效,明显减低了手术风险及并发症。

Objective To understand the clinical application value of mobile bedside CT （Portable Bedside CT, PBCT） - CereTom. Methods Sixty- four cases of neurological surgery in the head CT scan the patient bedside monitor were selected from February 2011 to December 2012, including hypertension, cerebral hemorrhage, hematoma in 36 cases, traumatic cerebral hemorrhage hematoma in 28 cases. All patients were using PBCT - CereTom in neurosurgical patients before and after a routine head CT scan line for monitoring hematoma surgery. Preoperative and intraoperative performed head CT scan slice thickness 5mm, scan time to 50ms. The disinfected was necessary when PBCT and operators need to enter the operating room, ultraviolet light for 20-30 minutes for PBCT, the support wheel to went through disinfectant disin- fection, the operator should wear face masks and quarantine isolation coat. Results Total 64 cases of intraoperative CT scan, hypertensive cerebral hemorrhage was in 36 cases, basal ganglia hematoma in 31 cases, cerebellar hematoma in 5 cases; traumatic cerebral hemorrhage in 28 cases; hemispheric hematoma in 13 cases, cerebellar hematoma in 3 cases, epidural hematoma 5 cases of subdural hematoma in 8 cases. All 64 patients with intracranial drainage tube were position in place after surgery, only a small residual hematoma were in 10 cases, but disappeared in 54 cases. PBCT- CereTom intraoperative head CT scan in each case was an average of 2 minutes, 20-30 minutes on average intraoperative examination （excluding sterilization time）, one - time success rate was 100%. During the inspections, the patient＇s condition was no increasing or no other accidents to occur. The PBCT- CereTom surgery in head CT images were found in all cases meet the requirements of CT diagnosis. Conclusions PBCT - CereTom application in neurosurgical patients, not only to provide high- quality video images, but also to real- time monitoring of surgery, it can significantly reduce the risk of surgery and complications.