颅脑外伤后急性脑肿胀30例临床研究.docVIP

颅脑外伤后急性脑肿胀30例临床研究 　　[摘要] 目的 通过分析我院颅脑外伤后急性脑肿胀患者临床资料，探讨其临床诊治要点及预后。 方法 收集2007年8月～2012年5月我院收治的颅脑外伤后急性脑肿胀患者共30例，评估入院时情况，行头颅CT扫描。其中20例患者行手术治疗，10例给予保守治疗。 结果 30例患者中，恢复良好1例，中残7例，重残7例，植物人状态生存2例，死亡13例，总死亡率为43%。 结论 急性脑肿胀患者伤情重，病情进展快且死亡率高，为进一步降低死亡率，提高临床疗效，还需要进一步加强相关的基础和临床研究。 [关键词] 脑外伤；急性脑肿胀；手术；预后 [中图分类号] R651.5 [文献标识码] B [文章编号] 2095-0616（2013）13-172-03 Clinical analysis of 30 cases of acute brain swelling after traumatic brain injury GAO Xiang1 CHEN Shiwen2 1.Department of Neurosurgery，Cao County People’s Hospital of Shandong Province，Cao County 274400，China；2.Department of Neurosurgery，the Sixth People’s Hospital， Shanghai Jiaotong University，Shanghai 200233，China [Abstract] Objective To evaluate the clinical feature and outcome of acute brain swelling after severe traumatic brain injury，we collected and analysised the clinical data of patients in our hospital. Methods A total of 30 cases of acute brain swelling after traumatic brain injury were collected from 2007 August to 2012 May in our hospital.The admission status were evaluated and computed tomography（CT） scan were performed. The operation was performed in 20 cases，with only conservative treatment in others. Results In 30 patients， 1 case had good outcome，moderate disability in 7 cases，severe disability in 7 cases， vegetative state survival of 2 cases and 13 cases died，the total mortality was 43%. Conclusion Patients of acute brain swelling always had a more severe trauma，and rapid progress with a high mortality rate.The further basic and clinical research is needed to decrease the mortality rate and improve the clinical efficacy. [Key words] Traumatic brain injury；Acute brain swelling；Operation；Prognosis 颅脑外伤后急性脑肿胀是重型颅脑损伤的严重并发症，表现为伤后4～14 h内，脑组织广泛肿胀，是严重颅脑创伤后死亡率高的主要原因之一。我院2007年8月～2012年5月共收治30例患者，手术治疗20例，保守治疗10例，死亡13例，死亡率为43%，现报道如下。 1 资料与方法 1.1 一般资料 我院2007年8月～2012年5月共收治30例颅脑外伤后急性脑肿胀患者，男22例，女8例，年龄9～78岁，平均（41.5±18.6）岁。受伤原因：车祸伤17例，坠落伤及跌伤9例，钝器打击伤4例，按损伤机制分类，减速性损伤23例，复合损伤7例。 1.2 意识状况 本组入院时均