原发性脑干损伤的临床特征和治疗  

Characteristics and treatment of Primary Brain Stem Injuries

作　　者：孙飞[1] 黎军[1] 马冲[1] 

机构地区：[1]江苏省徐州市中心医院神经外科,徐州221009

出　　处：《黑龙江医药》2009年第6期894-896,共3页Heilongjiang Medicine journal

摘　　要：目的:探讨原发性脑干损伤的治疗方法与效果。方法:对我院2004年以来的30例原发性脑干损伤的治疗与效果进行总结分析。其中10例有手术指征的急诊行开颅血肿清除去大骨瓣减压术,给予保持呼吸道通畅、亚低温、脱水、抗感染、钙拮抗剂、醒脑静注射液、高压氧等综合治疗。结果:死亡8例(26.7%);植物生存2例(6.7%),重残4例(13.3%),轻残7例(23.3%),恢复良好9例(30.0%)。8例死亡病人中,入院时GCS3分者4例,4分者3例,5分者1例。结论:及时手术、保持呼吸道通畅、亚低温、脱水、抗感染、钙拮抗剂、醒脑静注射液、高压氧等综合治疗可明显降低原发性脑干损伤的死残率。Objective:To explore the therapeutic approaches to primary traumatic injury in the brain stem and observe their effect on it.Methods:An analysis of therapeutic effect was carried out in 30 cases of primary injurey of brain stem since the year of 2004.Among them,10 cases were dealed with emergency surgery by hematoma clearance and decompression via craniotomy in addition to synthetical therapy such as maitainning expedite airway,sub-hypothermia,dehydration,anti-bacterial,Ca2 +antagonist,Xingnaojing injection,hyperbaric oxygenation, etc.Results:Death occurred in 8 cases(26.7%).Two cases (6.7%) lapsed into vegetative state,Four cases(13.3%) into severely disabled state,and 7 cases(23.3%) into moderately disabled state.Nine cases(30.0%) enjoyed a favorable recovery. Among the 8 death cases,four had a Glasgow Coma score (GCS) of 3,three a GCS of 4,and one a GCS score of 5.Conclusion: Synthetical therapy,such as emergency surgery, maitainning expedite airway,sub-hypothemia,dehydration,ant -bacterial,Ca^(2+) antagonist,Xingnaojing injection,hyperbaric oxygenation,etc,can immensely reduce the mortality and disability rate of the patients with primary injury of brain stem.

关 键 词：原发性脑干损伤 治疗 

分 类 号：R651.1[医药卫生—外科学]