26例脑外伤后综合征10年后临床随访  

Clinical follow-up of 26 patients with brain post-traumatic syndrome after 10 years

作　　者：刘诗翔[1] 刘波[1] 汪洪[1] 王文富[1] 

机构地区：[1]成都军区昆明总医院神经内科,650032

出　　处：《疑难病杂志》2005年第5期257-259,共3页Chinese Journal of Difficult and Complicated Cases

基　　金：云南省自然科学基金(编号:2002C0071M)

摘　　要：目的探讨脑外伤后综合征(PTS)远期(10年)的临床特征,为制定PTS的康复计划提供依据。方法总结并分析26例PTS患者10年后的临床表现、EEG、TCD、rCBF、CSF、心理测定、血液流变学、SPECT、CT、MRI等结果。结果10年后26例PTS患者中,大部分患者临床症状并未明显减轻,症状平均痊愈率仅为39.0%;26例EEG均正常;TCD示15例血流缓慢,以大脑中动脉明显;血液流变学检查示26例均有全血黏度和血浆黏度轻、中度升高;rCBF示20例大脑灰质血流量减少,以额叶明显;26例CSF均正常;心理测定21例有轻—中度抑郁,3例有焦虑,16例智商减退,24例记忆商减退;19例行SPECT检查的患者均有双侧额叶、颞叶血流量轻度减少;CT及MRI示6例有轻度脑萎缩。结论PTS10年后仍然有脑血液循环异常和认知功能异常。Objective To investigate the clinical manifestations in patients with brain post-traumatic syndrome （FlXS） after 10 years in order to provide basis for making the rehabilitation prognun. Metthods The results of clinical manifestation, electroencephalogram, transcranial Doppler（TCD）, regional cerebral blood flow（rCBF）, eerebrospinal fluid（CSF）, psychological test, single photon emission computerized tomography（SPECT）, computer tomog- raphy（CT） and magnetic resonance image（MRI） in 26 patients with brain FlXS were observed, summarized and analyzed. Results 10 years later,61% of the patients felt no relief and had light psychiatric symptoms contrarily. Their EEG and CSF were nomull; TCD revealed blood stream slow mainly in left middle cerebral artery in 15 eases; rCBF in 20 patients showed the reduction of blood flow, particularly in frontal lohes; psychological test proved that 21 pa- tients felt light-middle degree depression and 3 patients felt anxiety, the intelligence quotients in 16 patients and memory quotients in 24 patients decreased slightly; SPECT in 19 patients showed that blood flow decreased lightly in dou- ble frontal and temporal lobes; CT and MRI indicated that 6 patients had light brain atrophy. Conclusion The patients with PTS suffered from brain organic lesion, as a result, brain circulation and cognitive function disorders remain to exist even after 10 years.

关 键 词：脑外伤后综合征 临床随访 脑循环 认知功能 

分 类 号：R651.15[医药卫生—外科学]