脑弥漫性轴索损伤与弥漫性脑肿胀临床分析  

Clinical analysis of diffuse axonai injures associated with diffuse brain swelling

作　　者：张晓强[1] 高山[1] 王德明[1] 王湘[1] 

机构地区：[1]广安市人民医院脑外科,四川广安638000

出　　处：《西部医学》2009年第7期1157-1158,1160,共3页Medical Journal of West China

摘　　要：目的探讨脑弥漫性轴索损伤（DAD以及DAI合并弥漫性脑肿胀（DBS）患者的临床特征与预后。方法根据CT表现，将弥漫性轴索损伤病人分成两组，无弥漫性脑肿胀者为A组45例，合并弥漫性脑肿胀者为B组30例；对比两组病人GCS评分、瞳孔改变、手术及其预后的关系。结果A组45例，良好23例，中残3例，重残4例，死亡15例，GCS评分3～5分20例，单侧瞳孔散大10例，双侧瞳孔散大4例；B组30例，良好7例，中残3例，重残3例，死亡17例，GCS评分3～5分17例，单侧瞳孔散大6例，双侧瞳孔散大9例；手术A组10例，B组13例。结论脑弥漫性轴索损伤致残致死率高，合并弥漫性脑肿胀者病情更危重，预后极差。DBS对DAI的预后判断有重要意义。Objective To explore the clinical characteristics and prognosis of diffuse axonal injury （DAI） associates with diffuse brain swelling（DBS）. Method 75 patients with DAI, including 30 associates with DBS, were involved in the present study. The glasgow coma scale （GCS）, pupillarg charges and operation were observed. Results Of 45 cases with DAI, there were 23 cases with good prognosis, 3 cases with middle deformity, 4 cases with severe deformity, 15 cases death and 20 with 3 to 4 points of GCS. Of 30 patients with DAI associates with DBS, there were 7 with good prognosis, 3 cases with middle deformity, cases with severe deformity, 7 cases death and 6 with 3 to 4 points of GCS. Conclusions The mortality of patients with DAI is relatively high. The state of DAI associated with DBS is most dangerous and its prognosis is extremely bad.

关 键 词：脑弥漫性轴索损伤 脑肿胀 临床特征 预后 

分 类 号：R651.15[医药卫生—外科学]