摘要
目的在颅脑损伤患者的常规开颅血肿清除术中,通过术中使用B超处理急性脑膨出,总结B超在颅脑损伤手术中诊断急性脑膨出的价值。方法将44例重症颅脑损伤患者随机分为研究组和对照组。研究组患者行常规开颅血肿清除术时,估计术中出现急性脑膨出可能性大者,预先准备术中B超;对照组患者在术中出现脑膨出时,按常规先关颅,再送患者做CT检查。两组在明确脑膨出原因后,均采取相应的治疗方案。分别记录两组患者发生脑膨出到再次开颅手术时所需时间和术后3个月时格拉斯哥预后评分(GOS)。结果入院时研究组与对照组患者的GOS分别为(2.11±0.32)分和(2.14±0.24)分,差异无统计学意义(P>0.05);出院时GOS分别为(3.27±0.20)分和(2.65±0.22)分,差异有统计学意义(P<0.05);出院后3个月时分别为(3.45±0.21)分和(3.12±0.23)分,差异亦有统计学意义(P<0.05)。发生脑膨出到再次开颅手术所需时间,研究组明显短于对照组〔(2.10±0.14)h与(4.00±0.24)h,P<0.05〕。结论 B超对颅脑损伤手术中急性脑膨出的诊断具有重要的临床意义,可以在临床上进行推广。
Objective By using B-type ultrasound in conventional surgical hematoma evacuation process of the traumatic brain injury patients,we can conclude the value of B-type ultrasound in diagnosing acute encephalocele in craniocerebral injury operation.Methods 44 patients with severe brain injury were divided into research group and control group.Research group：traumatic brain injury patients were given conventional surgical hematoma evacuation,and those who are estimated to have intraoperative acute encephalocele are preconditioned with B-type ultrasound.Control group：we will close the cranium of the patients who had acute encephalocele during operation,and then they were sent to do CT examination at once.After find out the reason for the two groups,corresponding treatment was taken in the two groups.The time was recorded from the occurrence of acute encephalocele to the operation,as well as the GOS 3 month after the operation.Results GOS score of research group and control group when admitted was （2.11±0.32）and （2.14±0.24）respectively,and the difference was not significant（P0.05）.The score of both groups when discharged was（3.27±0.20 vs 2.65±0.22,P0.05）respectively,and the difference is significant（P0.05）;3 months after discharge the score was（3.45±0.21 vs 3.12±0.23）respectively,and the difference was also significant（P0.05）.As to the time from the occurrence of acute encephalocele to the operation,the research group was significantly shorter than that of the control group（2.10±0.14 h vs 4.00±0.24 h,P0.05）.Conclusion B-type ultrasound is of great clinical significance in acute traumatic brain injury surgery,and it can be promoted clinically.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第30期3473-3474,共2页
Chinese General Practice
关键词
颅脑损伤
开颅术
超声检查
脑膜膨出
诊断
Craniocerebral trauma
Craniotomy
Ultrasonography
Meningocele
Diagnosis
