创伤性大脑浅静脉损伤对颅脑创伤患者预后的影响  

Effects of traumatic cerebral superficial vein injury on the outcome of patients with craniocerebral trauma

作　　者：龙连圣[1] 王伟明[1] 江基尧[2] 赵朝晖[1] 辛志成[1] 李夏良[1] 张建忠[1] 蒋超超[1] 苏强[1] 章红梅[1] 

机构地区：[1]解放军98医院神经外科,浙江湖州313000 [2]上海交通大学仁济医院脑科中心,上海200127

出　　处：《中国急救医学》2010年第4期301-303,共3页Chinese Journal of Critical Care Medicine

基　　金：南京军区医学科学研究“十一五”计划课题（No.06MA14）

摘　　要：目的探讨大脑浅静脉损伤对创伤性脑梗死形成及颅脑创伤患者预后的影响。方法连续前瞻性地收集73例行急性硬膜下血肿和（或）脑内血肿清除加标准去骨瓣减压术的颅脑创伤患者的影像学和临床资料，按术中观察是否存在大脑浅静脉损伤分为大脑浅静脉损伤组和大脑浅静脉未损伤组，比较两组创伤性脑梗死的发生率及预后。结果术中发现存在大脑浅静脉损伤44例，其中发生创伤性静脉性脑梗死40例，预后不佳26例（59．1％）（死亡8例，植物生存11例，重残7例），预后较佳18例（40．9％）（中残7例，良好11例）；术中未发现大脑浅静脉损伤29例，其中发生创伤性脑梗死仅3例，预后不佳10例（34．5％）（死亡1例，植物生存3例，重残6例），预后较佳19例（65．5％）（中残8例，良好11例），两组比较差异有统计学意义（P〈0．05）。结论大脑浅静脉损伤是发生创伤性脑梗死的重要原因，大脑浅静脉损伤会严重影响颅脑创伤患者的预后。Objective To explore the effects of traumatic cerebral superficial vein injury on the occurrence of cerebral infarction and the outcome of patients with craniocerebral trauma. Methods 73 patients undergoing the evacuation of acute subdural and/or intracerebral hematomas and decompressive craniectomy were divided into cerebral superficial vein injury group （ n = 44 ） and non - cerebral superficial vein injury group （n = 29 ） and the incidence rate of cerebral infarction and the outcomes of the two groups were compared. Results 40 cases of traumatic cerebral infarction were found in the traumatic cerebral superficial vein injury group. 26 patients （59.1% ） had poor outcomes, and 18 cases （40.9%） had good outcomes among the 44 cases. Only 3 cases of traumatic cerebral infarction were found in the non -cerebral superficial vein injury group. 10 patients （34.5%） had poor outcomes, and 19 （65.5%） had good outcomes among the 29 patients （ P 〈 0.05 ）. Conclusion Cerebral superficial vein injury is the main cause of traumatic cerebral infarction. Patients with traumatic superficial cerebral vein injury were subject to poor prognosis and have relatively high morbidity and mortality.

关 键 词：颅脑创伤 大脑浅静脉 脑梗死 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]