CAJ | 학술논문

目的：分析和总结重度颅脑损伤的诊断和治疗的经验。方法选择2012年3月～2014年12月我院收治的58例重度颅脑损伤患者，将其入院情况、实验室及影像学检查、治疗方法、预后进行整理分析。结果58例患者体温、收缩压、血糖及白细胞计数均高于正常成人水平。采用高压氧、亚低温、去骨瓣减压术等手段后，58例患者4周后以格拉斯哥预后评分为Ⅰ～Ⅱ级（死亡或植物生存）18例，Ⅲ～Ⅴ级（神志清楚，自理生活能力有或无）40例。结论重度颅脑损伤患者格拉斯哥评分、体温、收缩压、血糖及白细胞计数及影像学检查结果可为病情监测、预后评估及治疗提供重要依据，在治疗中合理应用高压氧、亚低温、去骨瓣减压术可提高疗效。影像学检查有颅内血肿、脑疝、大面积脑梗死患者应予以高度重视。
목적：분석화총결중도로뇌손상적진단화치료적경험。방법선택2012년3월～2014년12월아원수치적58례중도로뇌손상환자，장기입원정황、실험실급영상학검사、치료방법、예후진행정리분석。결과58례환자체온、수축압、혈당급백세포계수균고우정상성인수평。채용고압양、아저온、거골판감압술등수단후，58례환자4주후이격랍사가예후평분위Ⅰ～Ⅱ급（사망혹식물생존）18례，Ⅲ～Ⅴ급（신지청초，자리생활능력유혹무）40례。결론중도로뇌손상환자격랍사가평분、체온、수축압、혈당급백세포계수급영상학검사결과가위병정감측、예후평고급치료제공중요의거，재치료중합리응용고압양、아저온、거골판감압술가제고료효。영상학검사유로내혈종、뇌산、대면적뇌경사환자응여이고도중시。
Objective To analyze and summarize the experience of diagnosis and treatment of severe craniocerebral injury. Methods 58 patients with severe craniocerebral injury from March 2012 to December 2014 were selected, their admission, laboratory and imaging examination, treatment and prognosis were analyzed. Results 58 cases of patients with Glasgow Score, body temperature, systolic blood pressure, blood sugar and white blood cell count were higher than normal. The hyperbaric oxygen, mild hypothermia, bone flap decompression means, 58 patients after 4 weeks according to the Glasgow Outcome Score I-II (death or vegetative survival) in 18 cases, III-V level (conscious and self-care ability of life have no or) 40 cases. Conclusion Severe craniocerebral injury patients with Glasgow Coma Scale, temperature, shrinkage pressure, blood glucose and white blood cell count and image examination results can be used for condition monitoring and prognosis assessment and treatment provides an important basis, in the treatment of reasonable application of hyperbaric oxygen, mild hypothermia, decompressive craniectomy can improve the curative effect. Imaging of intracranial hematoma, cerebral hernia, large area cerebral infarction patients should be highly valued.