可移动CT对颅脑手术麻醉恢复期病人的应用价值

APPLIACATION OF MOBILE CT IN PATIENTS DURING ANESTHESIA RECOVERY PERIOD AFTER CRANIOTOMY

目的探讨可移动CT(mCT)在神经外科颅脑手术后病人麻醉恢复期的应用价值。方法 2012年1月—2014年6月,在我科麻醉恢复室应用mCT对69例神经外科颅脑手术后病人进行扫描检查。结果进行mCT检查的原因:躁动或谵妄45例(65.2%),昏睡10例(14.5%),血压异常升高且控制不佳9例(13.0%),麻醉清醒后再次昏迷2例(2.9%),偏侧肢体运动障碍2例(2.9%),癫痫发作1例(1.5%)。mCT检查结果异常12例,阳性率为17.4%,其中颅内积气较多5例,术区血肿4例,蛛网膜下隙出血2例,远隔部位薄层硬膜下出血1例。因术区血肿重返手术室清除血肿2例。结论神经外科颅脑手术后病人在麻醉恢复室观察期间如发现生命体征异常、意识障碍等情况时,应用mCT检查能够第一时间发现可能存在的颅内异常,有利于及时对病人采取准确、有效的进一步处理,进而改善病人的预后。

Objective To assess the application value of mobile CT for patients during anesthesia recovery period after craniocerebral operations. Methods During Jan.2012-Jun.2014,in anesthetic recovery room of our department,69 patients after craniocerebral operations received scanography using mobile CT. Results The reasons for mobile CT scan were dysphoria or deliration（n=45,65.2%）,lethargy（n=10,14.5%）,abnormal hypertension（n=9,13.0%）,coma（n=2,2.9%）,hemiplegia（n=2,2.9%）and epilepsy（n=1,1.5%）.CT showed abnormal findings in 12（17.4%）cases,of which,five of intracranial pneumatosis,four of cerebellopontine hematoma,two of subarachnoid hemorrhage and one of supratentorial subdural hematoma.For two patients with hematoma in operation area underwent a second operation to evacuate the hematoma. Conclusion Once abnormal vital sighs or consciousness disorders are discovered in patients staying in the anesthetic recovery room after craniocerebral surgery,the intracranial abnormalities can be found at the first time using mobile CT,which is good for patients to take an accurate and effective management,so as to improve patient＇s prognosis.