摘要
目的探讨超声检查在颅脑创伤术中及术后的应用价值。方法对24例颅脑创伤患者在术中及术后行超声检查共发现病变35个。其中术中检查7例,使用3.5MHz探头,以无菌手术显微镜罩将探头包裹,探头与镜罩之间涂耦合剂,将探头轻置于脑组织表面向各个方向扫查,观察是否有迟发血肿,脑中线结构有无移位,脑室位置、大小、有无受压变形,脑组织及病变区回声表现。术后检查17例,采用不同频率探头显示远场、中场、近场的病变,一般情况下2～4MHz探头用于探查深度>10cm病变,3～6MHz探头用于探查深度为5～10cm病变,4～9MHz用于探查深度<5cm病变,在去除颅骨处皮肤表面进行探测并避免接触伤口。结果超声检查发现病变35个,CT及手术发现病变41个。与头颅CT检查或手术探查进行对比发现,硬膜外血肿及硬膜下血肿的超声检出率最高,实质内血肿次之,硬膜下积液及脑挫裂伤的检出率较低,总检出符合率为85.4%,较大的血肿均伴有中线结构移位,脑室受压变小或消失。结论颅脑创伤患者术中、术后超声与CT或手术检出符合率好,超声检查更方便、快速,有助于及时发现颅内迟发血肿及其他紧急并发症,节省抢救时间,提高抢救成功率,可以在颅脑创伤监护室使用。
Objective To explore the application of B-mode intra- and post-operative ultrasound in patients with traumatic brain injuries. Methods B-mode intra- and post-operative ultrasound were performed 35 times in 24 patients, including 7 times of intra-operation in 7 patients and 28 times of post-operation in 17 patients. Results During operation epidural hematomas in 3 cases as well as intraeranial hematomas in 2 cases, subdural hematomas in 1 case, diffused brain swelling in 1 case were found. After operation epidural hematomas were examined in 4 cases as well as subdural hematomas in 1 case, delayed intraeranial hematomas in 6 eases, scattered contusion and laceration of the brain in 12 cases, acute obstructive hydrocephalus in 1 case, and subdural hydroma in 4 cases. Six cases underwent operations again because of delayed hematomas, contusion and laceration of the brain. B-mode ultrasound was compared with CT scan and the total coincidence rate was 85.4%. Conclusions B-mode ultrasound is helpful to examine delayed hematomas and other emergent complications. It may save time and may improve rescue rate and has a good coincidence with CT scan. B-mode ultrasound may be widely used as a routine way in neurotrauma ICU.
出处
《中华医学超声杂志（电子版）》
2008年第2期17-19,共3页
Chinese Journal of Medical Ultrasound(Electronic Edition)
