床旁超声与颅脑CT在重型颅脑损伤去骨瓣减压的临床价值对比研究

Comparative Study of the Clinical Value of Bedside Ultrasound and Craniocerebral CT in Decompression of Bone Flap after Severe Craniocerebral Injury

目的比较床旁超声与颅脑CT在重型颅脑损伤去骨瓣减压中应用的不同价值。方法选择江苏省昆山市第一人民医院2016年1月—2018年10月中的40例重型颅脑损伤患者进行研究,均接受去骨瓣减压治疗,术后分别进行床旁超声与颅脑CT检查,比较两组检查方法的结果。结果床旁超声测定的中线移位宽度、侧脑室宽度为(1.22±0.55)cm、(0.74±0.09)mm,均与颅脑CT检查结果(1.33±0.68)cm、(0.68±0.06)mm比较,差异无统计学意义(t=0.796、1.897,P=0.429、0.062)。术后再次脑出血患者患者7例,其中经床旁超声证实的有6例,剩余1例未检出,检出率85.71%;经颅脑CT检查7例全部检出,检出率为100%。结论床旁超声与颅脑CT均能够良好监测重型颅脑损伤去骨瓣减压情况,相比之下床旁超声操作更为简便,更有推广价值。

Objective To compare the different value of bedside ultrasound and craniocerebral CT in decompression of bone flap after severe craniocerebral injury.Methods 40 patients with severe craniocerebral injury in Kunshan First People’s Hospital from January 2016 to October 2018 were selected for the study,all of whom received decompression treatment with bone flap removal.After the surgery,bedside ultrasound and craniocerebral CT examination were performed respectively,and the results of the two groups of examination methods were compared.Results The midline displacement width and lateral ventricular width measured by bedside ultrasound were(1.22±0.55)cm,(0.74±0.09)mm,and(1.33±0.68)cm,respectively.(0.68±0.06)mm had no statistical difference(t=0.796、1.897,P=0.429、0.062).There were 7 patients with cerebral hemorrhage after operation,6 of them were confirmed by bedside ultrasound,the remaining 1 was not detected,the detection rate was 85.71%;all 7 cases were detected by transcranial CT,the detection rate was 100%.Conclusion Both bedside ultrasound and craniocerebral CT can well monitor the decompression of bone flap after severe craniocerebral injury.