婴幼儿颅脑损伤的特点与治疗_临床医学论文.docVIP

婴幼儿颅脑损伤的特点与治疗_临床医学论文 婴幼儿颅脑损伤的特点与治疗_临床医学论文 【摘要】 目的 分析总结婴幼儿颅脑损伤的特点与治疗。方法 回顾性分析本组46例婴幼儿颅脑损伤的致伤原因、损伤类型、临床表现以及救治方法和预后状况并总结其相应的特点。结果 本组病例经过系统治疗均取得了较好的疗效，除2例(4.3%)重度弥漫性轴索损伤患儿最终因多器官功能障碍死亡外，痊愈38例(82.6%)，轻残3例（6.55%），中残3例（6.55%）。结论 婴幼儿颅脑损伤的主要临床特点是：（1）意识障碍往往迅速出现，持续时间较长，昏迷程度却往往和实际脑损伤程度有明显的差异；（2）伤后出现意识障碍的同时常伴有癫痫发作；（3）往往出现基础生命体征的紊乱；（4）脑挫伤及急性硬膜下血肿的发生率较低；（5）易出现基底节区及半卵圆中心部位的脑梗死；（6）预后明显好于成人。鉴于上述特点，婴幼儿颅脑损伤的治疗有着与成人不同的方面。 【关键词】 婴幼儿 颅脑损伤 特点 治疗 【Abstract】 Objective To analyze and summarize the characteristics and treatment of craniocerebral injury in infants. Methods The injury types, clinical manifestation, treatment method and prognosis of 46 infants with craniocerebral injury were retrospectively analyzed and then the homologue characteristics was summarized. Results Most patients had a good effect except that two cases died in severe diffuse axonal injury with the multiple organ dysfunctions. 38 cases (82.6%) were recovered, 3 cases (6.55%) light residual and 3 cases (6.55%) moderate disability. Conclusion The clinical features of infantile brain injury are: (1)The disturbance of consciousness used to take out rapidly, and lasts longer. There are apparent difference between the unconscious level and the actual brain damage level; (2)The seizures used to happen followed by disturbance of consciousness; (3)Vital signs are often the disorder; (4)The incidence of acute brain contusion and subdural hematoma are lower;(5)The cerebral infarction in the basal ganglia and semi-oval center is easily to happen;(6)The prognosis of craniocerebral injury the infant is better than that in adult. Respecting the characteristics, described as above, the treatment method for infantile craniocerebral injury should be different with the adults. 【Key words】 infant; craniocerebral injury; characteristics; treatment 随着社会的高速发展，交通工具的大量增长以及游乐设施的多样化，近年婴幼儿颅脑外伤的发生较前明显增多。ＣＴ、MRI的广泛应用对婴幼儿脑外伤的诊断提供了及时准确的帮助。婴幼儿神经系统的解剖、生理、病理生理等均与成人有所不同,网状上行系统发育尚不完善,因而其颅脑损伤也有别于成人,有着自己的特点［1］。我院神经外科自2005年1月～2007年6月共收治婴幼儿颅脑外伤病例46例，现就其特点及治