CAJ | 학술논문

　　目的探讨儿童颅脑创伤性大面积脑梗死的临床特点。方法对68例颅脑创伤性大面积脑梗死患儿进行回顾性分析。结果本组病例硬膜下出血最多(43.6%)，其次是硬膜外出血(23.5%)和脑出血(20.6%)，平均出血量65 ml；并发脑挫裂伤37例，蛛网膜下腔出血43例，颅骨骨折48例；四肢骨折24例，胸腹部脏器损伤15例，失血性休克30例。梗死发现时间主要在伤后1周内，其中4~7 d是发病高峰(32例)。根据格拉斯哥预后评分标准，恢复良好32例，轻度残疾15例，重度残疾9例，植物生存4例，死亡8例。结论儿童颅脑外伤性大面积脑梗死发病隐匿，CT或MRI是诊断的主要手段。及早发现，积极治疗，预后较成人良好。
　　목적탐토인동로뇌창상성대면적뇌경사적림상특점。방법대68례로뇌창상성대면적뇌경사환인진행회고성분석。결과본조병례경막하출혈최다(43.6%)，기차시경막외출혈(23.5%)화뇌출혈(20.6%)，평균출혈량65 ml；병발뇌좌렬상37례，주망막하강출혈43례，로골골절48례；사지골절24례，흉복부장기손상15례，실혈성휴극30례。경사발현시간주요재상후1주내，기중4~7 d시발병고봉(32례)。근거격랍사가예후평분표준，회복량호32례，경도잔질15례，중도잔질9례，식물생존4례，사망8례。결론인동로뇌외상성대면적뇌경사발병은닉，CT혹MRI시진단적주요수단。급조발현，적겁치료，예후교성인량호。
Objective To explore the clinical characteristics of posttraumatic cerebral massive infarction in children. Methods 68 cases were reviewed. Results There were 43 cases complicated with subarachnoid hemorrhage, 37 with brain contusion, 48 with fracture of skull, and the hematoma was subdural in 29 cases, epidural in 16 cases, and intracerebral in 14 cases. Other complications included fracture of limbs (24/68), thoracic or abdominal injury (15/68), and hemorrhagic shock (30/68). The infarction were found mostly in the first 7 d (range 2 h~13 d), and 32 cases within 4~7 d after the trauma. The outcome when discharged (according to the Glasgow outcome scale) was good re-covery in 32 cases, moderate disability in 15 cases, severe disability in 9 cases, vegetative state in 4 cases, and 8 cases died. Conclusion The feature of the posttraumatic cerebral massive infarction in children is usually concealed by primary injury. CT and MRI are the bases for di-agnosis. The outcome may be better than in the adults when early diagnosis and intervention has been produced.