三种策略在额叶脑挫裂伤治疗中的应用.docVIP

三种策略在额叶脑挫裂伤治疗中的应用 】目的探讨三种策略在额叶脑挫裂伤 治疗中的应用。方法163例额叶脑挫裂伤患者根据病 情轻重分为三组，分别采用保守治疗（118例）、脑 内血肿钻孔引流（15例）及开颅脑内血肿清除去骨瓣 减压（30例）三种策略进行治疗。结果保守治疗组 （第一组）恢复良好105例（89.0%）,轻度残疾13 例（11.0%）。钻孔引流组（第二组）恢复良好10例 （66.7%），轻度残疾4例（26.7%），重度残疾1例 （6.7%）。开颅手术组（第三组）恢复良好15例（50.0%）， 轻度残疾5例（16.7%），重度残疾3例（10.0%），植 物生存2例（6.7%）,死亡5例（16.7%）。结论根据 不同病情采用三种策略治疗额叶脑挫裂伤，可提高生 存率，减少创伤，提高生活质量。 关键词】额叶脑挫裂伤；保守治疗；脑内血肿 钻孔引流术；去骨瓣减压术 DOI： 10.14163/j.cnki.ll-5547/r.2015.18.043 Application of three strategies in the treatment of frontal lobe contusion HUANG Min-dong, ZOU Jian-dan. Department of Neurosurgery, Jieyang City People s Hospital，Jieyang 522000，China Abstract】 Objective To investigate application of three strategies in the treatment of frontal lobe contusion. Methods A total of 163 patients with frontal lobe contusion were divided by their severity into three groups. They received respectively conservative treatment (118 cases), intracerebral hematoma trepanation and drainage (15 cases)， and decompressive craniotomy intracerebral hematoma clearance (30 cases) . Results There were 105 cases with good recovery (89.0%) and 13 cases with mild disability (11.0%) in the conservative treatment group (first group) ? There were 10 cases with good recovery (66.7%)，4 cases with mild disability (26.7%) and 1 case with severe disability (6.7%) in the trepanation and drainage group (second group) . There were 15 cases with good recovery (50.0%), 5 cases with mild disability (16.7%), 3 cases with severe disability (10.0%), 2 cases with persistent vegetative state (6.7%) and 5 death cases (16.7%) in the craniotomy group (third group) . Conclusion Implement of three strategies by different disease condition can reduce invasion， and improve survival rate and life quality. Keywords】 Frontal lobe contusion； Conservative treatment； Intracerebral hematoma trepanation and drainage； Decompressive craniotomy 额叶脑挫裂伤有轻重之分，轻度也可变成重度， 根据不同程度的脑损伤，可采取不同的治疗方案。轻 度患者脑损伤轻，中线结构移位不明显，环池显示 清晰，脑干无受压，可采取保守治疗。如出现脑内 血肿，水肿程度一般，在伤后24 h后，中线结构 稍移位，特别是老