移动式床旁CT-CereTom在神经外科重症监护病房中的应用

APPLICATION OF PORTABLE BEDSIDE CT-CERETOM IN NEUROSURGERY INTENSIVE CARE UNIT

目的了解移动式床旁CT（Portable Bedside CT，PBCT）-CereTom在神经外科重症监护病房（NICU）的临床应用及其价值。方法2010年8月，我院引进国内首台移动式床旁CT—CereTom。至2012年12月，已对在NICU的2037例患者（均为病情危重，使用呼吸机辅助呼吸的患者），使用PBCT—CereTom行床旁头颅CT检查，其中脑出血817例、脑外伤614例、脑梗死411例、脑肿瘤195例。床旁头部CT扫描层厚5mm，扫描时间为50ms。PBCT及操作人员在进入NICU时需进行必要的消毒处理。结果经PBCT—CereTom的床旁头颅cT检查2037例，检查一次成功率100％。所有病例图像均符合CT诊断要求，其中9例因头颅位置低造成图像伪影，但不影响诊断。PBCT—CereTom行床旁头颅CT平扫每例平均为2min，床旁头颅CT检查平均20-30min，在进行床旁头部CT扫描时一定要密切注意患者各个管线的位置。在检查过程中，患者病情无加重或无其他意外发生。结论PBCT—CereTom在NICU的常规头颅CT检查可提供高质量神经影像学诊断，对病情危重患者适时进行检查，及时监测患者病情，明显减低了并发症，显著提高了愈后的生存质量。其具有快捷、经济和安全等优点。特别适合于对在NICU病情危重患者头部的检查。

Objective To understand mobile bedside CT （Portable Bedside CT, PBCT） - CereTom in neurosurgery intensive care unit （NICU） and its value in clinical applications. Methods From August 2010 to December 2012, 2037 patients reveived PBCT-CereTom line bedside head CT in the NICU. They were in critical condition and ventilatorassisted breathing, including 817 cases of cerebral hemorrhage, 614 cases of traumatic brain injury, cerebral infarction in 411 cases, 195 cases of brain tumors. Bedside head CT scan slice thickness was 5ram, scan time to 50ms. Disinfection was necessary for PBCT and the operator when entering the NICU. Results The PBCT- CereTom the bedside head CT inspection was performed for 2037 cases with a success rate of 100%. CT images in all cases meet the diagnostic requirement, including nine cases caused by low head position of the image artifacts which didn＇t affect the diagnosis. PBCT- CereTom bedside head CT scan lines need 2 minutes on average in each case, bedside head CT examination tonsured 20-30 minutes on average, during the bedside head CT scan in all patients must pay close attention to the location of the pipeline. During the inspections, without increasing the patient＇s condition or no other accidents occured. Conclusions PBCT- CereTom in the NICU routine head CT examination may provide high -quality neuroimaging diagnosis for ill patients. It has a fast, economic and security advantages, particularly suitable for critically ill patients in the NICU in the head of the inspection.