重型颅脑损伤移动CT床旁扫描的临床特点分析

目的对比分析重型颅脑损伤患者在神经外科重症监护室(NICU)做床旁移动CT(MCT)扫描和转运患者到放射科做常规CT(CCT)扫描时，所需要的医护人员数、累计工作量、相关并发症发生率等，总结移动CT临床应用技术特色和优势。 方法介绍重型颅脑损伤患者床旁移动CT扫描和常规CT扫描的方法，对比分析2010年8月至2015年12月北京军区总医院附属八一脑科医院1917例在NICU做移动CT床旁扫描和593例在放射科做常规CT扫描的相关并发症及技术操作失误、需要的医护人员数及累计工作量，并依据伤情将MCT组和CCT组分为特重型(GCS 3~5分)和重型(GCS 6~8分)两个亚组，分析移动CT在颅脑损伤的临床应用技术特色和优势。 结果在NICU应用移动CT为重型颅脑损伤患者行床旁移动CT扫描，操作简便安全，无需转运患者。移动CT组中GCS 3~5和GCS 6~8分亚组的并发症发生率分别为3.32%和0%，而相同GCS亚组的常规CT扫描组并发症发生率高达26.87%，18.82%(P<0.05)。移动CT床旁扫描仅需要3名医护人员参加，GCS 3~5分和GCS 6~8分亚组耗时分别为(15.02±1.53) min和(13.01±1.31) min，3人累计工作耗时分别为(45.05±1.54) min和(39.03±1.32) min，而转运患者到放射科做常规CT扫描需要5名医护人员参加，其与MCT相同GCS亚组的耗时分别为(40.04±4.32) min和(30.03±3.13) min，5人的累计工作耗时高达(200.23±4.45) min和(150.18±3.35) min (P<0.05)。 结论在NICU使用移动CT床旁扫描操作简便，安全可靠，可显著减少因院内转运患者到放射科做常规CT扫描引起的相关并发症，明显减少医护人员数量和累计工作时间。

Clinical features of mobile CT in patients with severe traumatic brain injury

ObjectiveTo compare with severe craniocerebral injury patient on-site scanning by bedside mobile CT(MCT) in neurosurgical intensive care unit (NICU) or scanning by conventional CT(CCT) in Radiology with patient's intra-hospital transport. It analyses the number of staff required, cumulative workload, the incidence of complications between MCT and CCT scanning. The article summarize the clinical feature and Technology advantage of mobile CT. MethodsIt introduces CT scanning methods for severe craniocerebral injury by way of bedside MCT scanning with 1917 cases patients in the NICU and by CCT scanning with 593 cases patients in Radiology with patient's intra-hospital transport. It compared with the number of staff required, cumulative workload, the incidence of complications between MCT and CCT scanning. According to degree of injury, severe craniocerebral injury was divided into subgroups of GCS 3~5 and GCS 6~8. The clinical feature and technology advantage of mobile CT were discussed in this paper. ResultsThe method of MCT bedside scanning in NICU for craniocerebral injury is simple and easy to operate, and no intra-hopspital transport of patients. By way of MCT bedside scanning in NICU, the complication rates were 3.32% and 0% with subgroups of GCS 3~5 and GCS 6~8 score respectively (P<0.05). By way of CCT scanning in Radiology, the complication rates were 26.87% or 18.82% with subgroups of GCS 3~5 and GCS 6~8 scores respectively, which were much higher than those of MCT scanning(P<0.05). The MCT bedside scanning, it need 3 staffs to participate works, including one CT technician, one nurse and one assistants, and its time consuming was (15.02±1.53) min and (13.01±1.31) min in subgroup of GCS 3~5 and GCS 6~8 respectively. And the total cumulative time-consuming were (45.05±1.54) min and (39.03±1.32) min with same GCS subgroups as MCT respectively. But, the CCT scanning, it required 5 staffs to participate works, including one doctor, one nurse , two assistants and one CT technician, and its time consuming was (40.04±4.32) min and(30.03±3.13) min in subgroup of GCS 3~5 and GCS 6~8 respectively. And the total cumulative time-consuming were (200.23±4.45) min and (150.18±3.35) min with same GCS subgroups as MCT respectively, which were mucu higher than those of MCT. ConclusionThe use of mobile CT bedside scanning in NICU, its operation is simple, safe and reliable. It can significantly reduce the complications caused by intra-hospital transfer patients to Radiology with CCT scanning, and reduces the number of staffs or total cumulative time-consuming remarkably in this clinical trial.