婴幼儿急性颅脑损伤的特点与治疗(附46例临床分析)  

Characteristics and Treatment of Brain Injury in Infants:A clinical report 46 cases

作　　者：杜斌[1] 俞民[1] 董亚南[1] 

机构地区：[1]山东大学附属济南市中心医院神经外科,山东省济南市250013

出　　处：《中国全科医学》2008年第19期1789-1790,共2页Chinese General Practice

摘　　要：目的分析总结婴幼儿颅脑损伤的特点与治疗。方法回顾性分析研究本组46例婴幼儿颅脑损伤患者的损伤类型、临床表现、救治方法和预后状况并总结其相应的特点。结果(1)本组患儿中闭合性颅脑损伤38例,开放性颅脑损伤8例;(2)主要临床表现为伤后不同程度的意识障碍;(3)手术治疗19例,保守治疗27例;(4)本组患儿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因多器官功能障碍死亡外,其他患儿痊愈38例(82.6%),轻度残疾3例(6.55%),中度残疾3例(6.55%)。结论婴幼儿的颅脑外伤在脑外伤中属于较特殊的一种类型,有与成人不同的特点,同时小儿神经系统处于发育阶段,尚未成熟,其代偿能力和修复能力较强,对颅脑损伤的承受力较大。机体的其他器官生理机能旺盛,不易出现相应的并发症。功能的障碍多为伤后的应激性变化,恢复较快。在日常诊疗过程中应充分考虑其特点并采取有针对性的治疗方法,会取得十分理想的疗效。Objective To analyze and summarize the characteristics and treatment of brain injury in infants.Methods The data of 46 infant patients with brain injury were retrospectively analyzed on the injury types,clinical manifestation,treatment method and prognosis,and their homologue characteristics were summarized.Results There were 38 infant patients whose injury type was closed and 8 patients whose injury type was open.The major clinical manifestation was consciousness disorder after injury.Nineteenth patients received the surgery operation and twenty-seven received the conservative treatment.Most of the patients gained better results after systemic treatment,with an exception of 2 cases(4.3%) who died of severe diffuse axonal injury complicated by multiple organ dysfunction died.Of which 38 cases(82.6%)were recovered;3 cases(6.55%)lightly handicapped and 3 cases(6.55%) moderately handicapped.Conclusion The infant brain injury is a special category in brain trauma,with sharp-cut characteristics in contrast to those of adult.The nervous system of infant has been in growth stage,it is of strong capability of compensation and restoration.The relevant complications rarely occur.Most of the dysfunctions belong to stressed changes that can restore quickly.A satisfactory therapeutic effect can be generally gained as we take a scientific treatment for it based on fully considering the characteristics of the disease clinically.

关 键 词：颅脑损伤 疾病特征 治疗结果 

分 类 号：R726.5[医药卫生—儿科]