改变精神状态患者的大脑CT:第三级护理急诊部审查
Maan Jamjoom1,2,3, Faisal Boker3, Abeer Alraiqi3
1Emergency Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.
Cureus
|February 3, 2026
概括
改变精神状态 (AMS) 脑部CT扫描显示,近三分之一的急诊室患者的脑部CT扫描结果呈阳性,识别出了诸如出血和中风等关键疾病. 需要进一步的研究来开发适当的神经成像使用的风险工具.
科学领域:
- 紧急医疗 紧急医疗
- 神经学 神经学
- 放射学 放射学是指放射学
背景情况:
- 改变精神状态 (AMS) 是一个常见的,非特定的急诊室 (ED) 呈现,原因多种多样.
- 对于AMS患者来说,关于神经成像,特别是CT脑部扫描的临床决策是具有挑战性的,因为过度使用 (成本,辐射) 和不足使用 (延迟诊断) 的风险.
- 目前在AMS病例中CT脑部利用的实践缺乏标准化,导致患者护理不一致.
研究的目的:
- 分析急诊室患者的CT脑部发现,这些患者表现出精神状态的改变.
- 在这个患者群体中评估CT脑成像的必要性和产量.
- 为在AMS中CT利用的标准化指南的制定提供信息.
主要方法:
- 在吉达的阿卜杜勒阿齐兹国王医疗城进行了分析横截面研究.
- 从2023年1月到2023年12月收集了数据,包括所有患有AMS的ED患者,这些患者接受了CT脑成像.
- 分析了患者的人口统计,并发症和CT发现.
主要成果:
- 在接受CT脑部扫描的112名AMS患者中,有29.5%的患者呈阳性结果.
- 最常见的积极发现是内出血 (9.8%) 和中风 (7.1%).
- 常见的并发症包括高血压 (61.6%) 和糖尿病 (50%);CT阳性因成像时间不显著变化 (p = 0.477).
结论:
- 脑部CT成像在相当一部分AMS患者中发现了严重的疾病,如出血和中风.
- 这些发现支持对高风险AMS患者进行CT脑部扫描的必要性,特别是那些患有并发症,焦点缺陷,创伤或服用抗凝药的人.
- 未来对照组的前性研究和经过验证的风险分层工具对于优化在AMS病例中CT利用至关重要.
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