中国医药导刊
中國醫藥導刊
중국의약도간
CHINESE JOURNAL OF MEDICAL GUIDE
2014年
4期
659-660,662
,共3页
重型颅脑损伤%急性脑膨出%临床分析
重型顱腦損傷%急性腦膨齣%臨床分析
중형로뇌손상%급성뇌팽출%림상분석
Severe Craniocerebral Injury%Acute Encephalocele%Clinical Analysis
目的：探讨重型颅脑损伤患者术中急性脑膨出的临床特点。方法：回顾性分析31例重型颅脑损伤术中脑膨出患者的临床资料，总结分析脑膨出原因及其治疗结局。结果：本组31例患者经治疗，恢复良好4例(12.9%)，中残6例(19.4%)，重残5例(16.1%)，死亡16例(51.6%)，患者死亡率随GCS评分降低而增高，其中GCS评分为3~5分者死亡率显著高于6~8分及9~10分患者(P<0.05)；31例患者脑膨出原因分别为弥漫性脑肿胀14例(45.2%)，迟发性颅内血肿8例(25.8%)，广泛性脑挫裂伤合并颅内多发血肿或严重脑水肿9例(29.0%)。结论：重型颅脑损伤术中急性脑膨出患者的治疗较为复杂，治疗结局与术前GCS评分、脑膨出原因具有密切关系，但术前给予全面评估，术中积极配合其他治疗措施均对改善预后具有重要意义。
目的：探討重型顱腦損傷患者術中急性腦膨齣的臨床特點。方法：迴顧性分析31例重型顱腦損傷術中腦膨齣患者的臨床資料，總結分析腦膨齣原因及其治療結跼。結果：本組31例患者經治療，恢複良好4例(12.9%)，中殘6例(19.4%)，重殘5例(16.1%)，死亡16例(51.6%)，患者死亡率隨GCS評分降低而增高，其中GCS評分為3~5分者死亡率顯著高于6~8分及9~10分患者(P<0.05)；31例患者腦膨齣原因分彆為瀰漫性腦腫脹14例(45.2%)，遲髮性顱內血腫8例(25.8%)，廣汎性腦挫裂傷閤併顱內多髮血腫或嚴重腦水腫9例(29.0%)。結論：重型顱腦損傷術中急性腦膨齣患者的治療較為複雜，治療結跼與術前GCS評分、腦膨齣原因具有密切關繫，但術前給予全麵評估，術中積極配閤其他治療措施均對改善預後具有重要意義。
목적：탐토중형로뇌손상환자술중급성뇌팽출적림상특점。방법：회고성분석31례중형로뇌손상술중뇌팽출환자적림상자료，총결분석뇌팽출원인급기치료결국。결과：본조31례환자경치료，회복량호4례(12.9%)，중잔6례(19.4%)，중잔5례(16.1%)，사망16례(51.6%)，환자사망솔수GCS평분강저이증고，기중GCS평분위3~5분자사망솔현저고우6~8분급9~10분환자(P<0.05)；31례환자뇌팽출원인분별위미만성뇌종창14례(45.2%)，지발성로내혈종8례(25.8%)，엄범성뇌좌렬상합병로내다발혈종혹엄중뇌수종9례(29.0%)。결론：중형로뇌손상술중급성뇌팽출환자적치료교위복잡，치료결국여술전GCS평분、뇌팽출원인구유밀절관계，단술전급여전면평고，술중적겁배합기타치료조시균대개선예후구유중요의의。
Objective:To discuss the clinical features of patients with acute encephalocele in operation of severe craniocerebral injury. Methods:The clinical data of 31 patients with acute encephalocele in operation of severe craniocerebral injury were retrospectively analyzed, and the causes of encephalocele and treatment outcome was summarized. Results:After the treatment, 4 patients(12.9%) had good recovery, 6 patients(19.4%) were moderate disability, 5 patients(16.1%) were severe disability, and 16 patients(51.6%) died;patients’ mortality were increased with the reducing of GCS, and patients with GCS 3~5 had significantly higher mortality than with GCS6-8 and GCS9-10(P<0.05); causes of acute encephalocele were diffuse brain swelling, 14 cases(45.2%), delayed intracranial hematoma, 8 cases(25.8%), and cerebral contusion merge multiple intracranial hematoma, 9 cases(29.0%). Conclusion:The treatment of patients with acute encephalocele in operation of severe craniocerebral injury is complex, treatment outcomes were related with GCS before the operation and causes of acute encephalocele, comprehensive assessment of preoperative, other actively cooperate treatment measures intraoperative have important significance in improving the prognosis.
