超声在颅脑创伤术中及术后的临床应用价值

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。

Application of intra-and post-operative ultrasound in traumatic brain injury

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 intracranial hematomas in 2 cases,subdural hematomas in 1 case,diffused brain swelling in 1 case were found.After operation epidural h...