枕部着力脑外伤临床探究.doc

枕部着力脑外伤临床探究[摘要] 目的：了解枕部着力导致的脑外伤的临床特点与疗效。方法：本科收治枕部着力脑外伤患者65例，均行头颅CT检查，采用手术与非手术法进行治疗，并分析其疗效。结果：本组患者经治疗后良好38例，良好率为58.5%；中度残疾7例，占10.8%；重度残疾3例，占4.6%；植物生存1例，占1.5%；死亡16例，死亡率为24.6%。结论：枕部着力脑损伤死亡率较高，临床诊治中应严密观察病情，及时复查颅脑CT与手术。 [关键词] 枕部着力；脑外伤；颅脑损伤；疗效 [中图分类号] R651.1+5 [文献标识码]C[文章编号]1674-4721（2011）07（c）-242-02 Clinical study of cerebral trauma caused by occipital force ZHAO Zhongfu1, ZHENG Lu2* 1.Xuchang Central Hospital, Henan Province, Xuchang 461000, China; 2.Department of Neurosurgery, 150th Central Hospital of the People’s Liberation Army, Henan Province, Luoyang 471031, China [Abstract] Objective: To find out the clinical features and therapeutic effect of cerebral trauma caused by occipital force. Methods: 65 cerebral trauma patients our department admitted were examed by head CT scan, and treated by surgical and non-surgical method. The therapeutic effects were analyzed and compared. Results: After treatment 38 patients with a good therapeutic effect, good therapeutic effect rate was 58.5%; 7(10.8%) patients with moderate disability; 3(4.6%) patients with severe disability; 1(1.5%) patient with vegetative survival; 16 death patients, death rate was 24.6%. Conclusion: The mortality rate of occipital force is high, treatment of disease should be closely observed, timely review of brain CT and surgery are required. [Key words] Occipital force; Cerebral trauma; Traumatic brain injury; Therapeutic effect 枕部后仰着力可导致对冲部位的损伤，产生较严重的复杂脑外伤，伤情急，易恶化，致死率较高，严重危害了患者的生命安全[1]。为了了解枕部着力导致的脑外伤的临床特点与疗效，本文回顾性分析本科2005年1月～2011年1月收治的枕部着力脑外伤患者65例的临床资料，现将诊治体会报道如下： 1 资料与方法 1.1 一般资料 本科2005年1月～2011年1月收治枕部着力脑外伤患者65例，男41例，女24例，年龄6～78岁，平均（39.6±10.4）岁。致伤原因：跌打伤15例，车祸事故伤32例，撞击伤7例，坠落伤11例。加速伤7例，减速伤58例。就诊时间距受伤时间：20 min～4 h。伤前并发症：高血压5例，糖尿病2例，慢性支气管炎1例。入院时的GCS评分：10 ml，幕上血肿或挫伤灶体积30 ml者，均行急诊开颅手术，包括：18例清除脑内血肿及挫伤灶，8例去骨瓣减压，2例清除碎骨并清除硬膜外血肿，1例复位凹陷骨折并清除硬膜外血肿，11例于术后行气管切开术。疗效判定标准采用GOS标准。 2 结果 本组患者良好（患者虽有轻度缺陷，但恢复正常生活）38例，良好率为58.5%；中度残疾7例，占10.8%；重度残疾3例，占4.6%；植物生存1例，占1.5%；死亡16例，死亡率为24.6%。死亡原