进展型脑挫裂伤早期手术干预的指征和时机探讨  

Timing and indication for early operative intervention of progressive cerebral contusion and laceration

作　　者：马力[1] 崔洁[2] 

机构地区：[1]安徽池州市人民医院神经外科,池州247000 [2]三峡大学第三临床医学院.葛洲坝中心医院,宜昌443002

出　　处：《中国实用神经疾病杂志》2009年第3期4-6,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨进展型脑挫裂伤早期手术干预的指征和时机。方法280例进展型脑挫裂伤患者分为3组,早期手术干预组(A组)70例,病情初步进展,手术时间为入院3d内。延迟手术组(B组)112例,病情进展显著,入院4～10d手术。未手术组(C组)98例。统计手术患者术前GCS评分,并对患者术前意识、生命体征、瞳孔、颅高压征及动态复查CT结果量化评分,以GOS评价3组疗效。结果手术组较非手术组病死率、致残率显著降低,当GCS评分出现下降、病情进展量化评分6分以内、病程不超过3d及时手术可明显提高治愈率。结论早期手术干预进展型脑挫裂伤,可以明显降低病死率和致残率,改善预后,提高患者生存质量。Objective To investigate the timing and indication for early operative intervention of progressive cerebral contusion and laceration. Methods Two hundred and eighty patients of progressive cerebral contusion and laceration were divided into three groups. Group A （early operative intervention）were 70 cases, the disease progression was minimal and duration of surgery in less than 3 days. Group B （delay operation）were 112 cases, the disease in the serious progression and surgical delays in 4 to 10 clays. Group C （nonoperative management）were 98 cases. A comparison analysis of operation groups was eonclucted based on the scores of GCS, the conscious status , vital signs, pupillar change, intracranial hypertension signs and CT scanning results before operation. The efficacy was evaluated with GOS between three groups. Results Operation treatment significantly reduced the rate of deformity and mortality in progressive cerebral contusion and laceration. The operation in a timely manner can significantly increase the curative rate , when the GCS scoresd declined, disease progress grades was within 6 points and length of stay was less than 3 days. Conclusion The rates of deformity and mortality were distinctly reduced in early operative intervention for progressive cerebral contusion and laceration. The prognosis was improved and the quality of life was increased.

关 键 词：进展型脑挫裂伤 手术指征 手术时机 早期 

分 类 号：R651.15[医药卫生—外科学]