去骨瓣减压术后使用B超颅内损伤情况的初步经验-SAGEJournals.PDFVIP

Hong Kong Journal of Emergency Medicine Preliminary experience of assessment of intracranial lesions by ultrasound in multiple trauma patients undergoing craniectomy B X Lu , M Zhang , JX Yang , SX Xu , JX Gan Obj ective: To explore the feasibility and reliability of B-mode ultrasound for assessment of intracranial lesions in multiple trauma patients who had undergone craniectomy. Desig n: Single-centre study. Setting : A 16- bed emergency intensive care unit (ICU) in the emergency department of 2nd Affiliated Hospital of Zhejiang University School of Medicine from July 2006 to June 20 10. Methods: We retrospectively analysed 13 multiple trauma patients with severe head injury admitted to the emergency department of 2nd Affiliated Hospital of Zhejiang University School of Medicine. All 13 patients were admitted to the ICU after craniectomy and received mechanical ventilation. Computed tomography (CT) were conducted when patients consciousness, pupillary size, light reflex changed apparently, or if the bone window tension and the intracranial pressure increased unexpectedly. Head ultrasonography was performed within 2 hours of CT scanning. Results: Ultrasonography revealed 18 pathological changes in the 13 patients. CT and a second operation helped to identify 23 pathological changes. The results of B-mode ultrasound were compared with those of CT and the coincidence rate was 78.3%, with no significant difference in the diagnosis of delayed haematoma or midline shift (Kappa=0.898, p0.05). Conclusions: Transcranial ultrasonography may be a useful tool for monitoring post-operation intracranial lesions in multiple trauma patients with severe head injury. It is an effective supplement to CT. (Hong Kong j .emerg.med. 20 13;20:34-39) B ICU 16 2006 7