颅脑外伤脑疝的早期观察及诊断  

The Early Clinical Observation and Diagnostic Points of Encephalocele for Acute Head Injury

作　　者：刘文锋[1] 林源泉[1] 贾军[1] 钟天安[1] 黄仕春[1] 张浚[1] 

机构地区：[1]深圳市龙岗中心医院,广东深圳518172

出　　处：《国际医药卫生导报》2004年第14期14-16,共3页International Medicine and Health Guidance News

摘　　要：目的探讨颅脑外伤脑疝的早期诊断要点及有效治疗手段。方法对123例急性颅脑外伤脑疝患者的临床特点、并发症和诊治效果等进行总结分析。结果本组存活82例,恢复良好34例(27.6%),中残22例(17.9%),重残15例(12.2%),植物生存11例(8.9%);死亡41例,死亡率为33.3%,死于并发症19例(15.4%)。瞳孔散大时间<30分的生存率为78.0%,GCS评分3～5分、6～8分的死亡率分别为41.9%和28.6%。结论抢在脑疝形成早期诊断颅内血肿,及时抢救,清除血肿、降低颅内压,尽早解除脑疝,是提高抢救成功率的关键。入院时GCS评分和瞳孔变化相结合是判断颅脑损伤病情发展和预后的重要指标。伤后距手术时间越短,特别是脑疝后距手术时间越短,手术效果越好。Objective To investigate the early diagnostic points and prophylactic therapeuticmethods of encephalocele for acute head injury.Methods One hundred and twenty-three head injuredpatients with encephalocele were analysed retrospectively and the clinical characteristic, intercur-rent diseases and the diagnosing and treated effects wer summarixed.Results Among 123 patients,82cases were survived.34 cases were cured(27.6%).22 cases were moderate disability(17.9%).And severedisability was seen in 15 cases(12.2%).Brain declining was seen in 11 cases(8.9%).41 cases were dead.And the mortality was 33.3%.19 cases died of intercurrent diseases(15.4%).The survival rate of thepatients the time when mydriasis happened<30 minutes was 78.0%.And the mortality whitch GCS grades were3～5 score and 6～8 score were respectively 41.9% and 28.6%.Conclusion It’s the key of enhance thesuccessful saving rate to diagnose the intracranial haematoma as early as possible before theencephalocele forming,and actualize salvage in time,c1ean out haematoma to reduce intracranial pressureand relieve encephalocele.The GCS grade combined with pupil change is an important index of estimatingthe state development and prognosis of head injury.The shorter is the time between being injured ,especially forming head hemia and receiving surgery,the better is the postoperative effect.

关 键 词：颅脑外伤 脑疝 诊断 

分 类 号：R651.1[医药卫生—外科学]