中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
21期
1500-1502
,共3页
脑静脉%颅脑损伤%脑挫伤%颅骨骨折
腦靜脈%顱腦損傷%腦挫傷%顱骨骨摺
뇌정맥%로뇌손상%뇌좌상%로골골절
Cerebral veins%Cranialcerebral trauma%Brain contusion%Skull fractures
目的 探讨外伤后脑浅表大静脉梗死的相关因素和治疗措施.方法 从2003年1月至2008年10月对74例脑浅表大静脉损伤按术中发现分为3组:1组:脑浅表大静脉损伤合并局部脑挫伤和脑内血肿、急性硬模下血肿.2组:脑浅表大静脉损伤合并局部脑挫伤和脑内血肿、急性硬模下血肿、损伤区颅骨骨折.3组脑浅表大静脉损伤合并损伤区颅骨骨折、急性硬模下血肿,无明显脑挫伤、脑内血肿,并按性别、年龄、术前GCS评分、脑疝情况分组.结果 1组28例,2组39例,3组7例,各组的损伤静脉不同,差异有统计学意义(P<0.01).1组和2组有37例患者合并有不同程度的脑梗死,3组有2例发生脑梗死.脑梗死与性别、年龄、术前GCS评分、脑疝均无关.结论 脑浅表大静脉损伤主要南局部颅骨骨折或对冲伤、剪切伤所致,合并有脑挫伤时脑梗死多见,术中应注意保护受损腩浅表大静脉及周围的静脉网,及时清除颅内血肿,必要时大骨瓣充分减压,降低颅高压,术后注意稀释血液,防止受损静脉栓塞.
目的 探討外傷後腦淺錶大靜脈梗死的相關因素和治療措施.方法 從2003年1月至2008年10月對74例腦淺錶大靜脈損傷按術中髮現分為3組:1組:腦淺錶大靜脈損傷閤併跼部腦挫傷和腦內血腫、急性硬模下血腫.2組:腦淺錶大靜脈損傷閤併跼部腦挫傷和腦內血腫、急性硬模下血腫、損傷區顱骨骨摺.3組腦淺錶大靜脈損傷閤併損傷區顱骨骨摺、急性硬模下血腫,無明顯腦挫傷、腦內血腫,併按性彆、年齡、術前GCS評分、腦疝情況分組.結果 1組28例,2組39例,3組7例,各組的損傷靜脈不同,差異有統計學意義(P<0.01).1組和2組有37例患者閤併有不同程度的腦梗死,3組有2例髮生腦梗死.腦梗死與性彆、年齡、術前GCS評分、腦疝均無關.結論 腦淺錶大靜脈損傷主要南跼部顱骨骨摺或對遲傷、剪切傷所緻,閤併有腦挫傷時腦梗死多見,術中應註意保護受損腩淺錶大靜脈及週圍的靜脈網,及時清除顱內血腫,必要時大骨瓣充分減壓,降低顱高壓,術後註意稀釋血液,防止受損靜脈栓塞.
목적 탐토외상후뇌천표대정맥경사적상관인소화치료조시.방법 종2003년1월지2008년10월대74례뇌천표대정맥손상안술중발현분위3조:1조:뇌천표대정맥손상합병국부뇌좌상화뇌내혈종、급성경모하혈종.2조:뇌천표대정맥손상합병국부뇌좌상화뇌내혈종、급성경모하혈종、손상구로골골절.3조뇌천표대정맥손상합병손상구로골골절、급성경모하혈종,무명현뇌좌상、뇌내혈종,병안성별、년령、술전GCS평분、뇌산정황분조.결과 1조28례,2조39례,3조7례,각조적손상정맥불동,차이유통계학의의(P<0.01).1조화2조유37례환자합병유불동정도적뇌경사,3조유2례발생뇌경사.뇌경사여성별、년령、술전GCS평분、뇌산균무관.결론 뇌천표대정맥손상주요남국부로골골절혹대충상、전절상소치,합병유뇌좌상시뇌경사다견,술중응주의보호수손남천표대정맥급주위적정맥망,급시청제로내혈종,필요시대골판충분감압,강저로고압,술후주의희석혈액,방지수손정맥전새.
Objective To analyze the correlative factors of traumatic embolism in superficial cerebral vein and explore their corresponding treatments. Methods A total of 74 cases were divided into 3 groups according to their injury mechanisms. Group A: traumatic brain injury in superficial cerebral vein with cerebral contusion, acute intracerebral hematoma and subdural hematoma in the same place; Croup B; traumatic brain injury in superficial cerebral vein with acute intracerebral hematoma, subdural hematoma and skull fracture in the same place; Group C: traumatic brain injury in superficial cerebral vein with acute subdural hematoma and skull fracture in the same place, without cerebral contusion or acute intracerebral hematoma. They were divided into different groups according to gender, age, pre-operative GCS and cerebral hemia. Results Among 74 cases, 28, 39 and 7 cases belonged to groups A, B and C respectively. There was significant difference among injured veins in three groups (P <0. 01). Cerebral infarction was found in 37 cases in groups A and B while only 2 cases in group C. Cerebral infarction had no correlation with sex, age, pre-operative GCS and cerebral hernia. Conclusion Injuries in superficial cerebral vein are mainly caused by skull fracture, contre-coup injury and shearing force. Cerebral infarction often exists if there is cerebral contusion. It is necessary to protect injured primary superficial cerebral veins and ambient venous network, remove intracranial hematoma and large bone flap to reduce intracranial hypertension and dilute blood post-operatively to prevent venous embolism.
