外伤性脑梗塞的临床治疗体会(附51例报告)  

Clinical experience on treatment of traumatic cerebral infarction(Report of 51 cases)

作　　者：冯裕修 陈智国[1] 蔡望青[2] 

机构地区：[1]广宁县人民医院脑科中心,广东广宁526300 [2]中山大学孙逸仙纪念医院神经外科,广州510120

出　　处：《岭南现代临床外科》2014年第3期325-328,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨外伤性脑梗塞临床特点及预防、治疗方法。方法回顾分析51例外伤性脑梗塞患者的诊断、治疗方法及结果。结果 34例患者行开颅血肿清除、挫裂伤病灶清除,其中22例患者行去骨瓣减压术,12例患者行内减压术。7例患者进行再次开颅清除血肿清除、减压术,死亡7例。全部诊断外伤性脑梗塞的患者均予扩容、改善循环、解痉、高压氧、激素及降低颅内压等治疗;明显蛛网膜下腔出血的患者予多次腰穿或腰大池持续引流等处理。随访2年,按GOS分级判断预后,良好22例,中残9例,重残7例,植物生存6例。结论颅脑外伤治疗过程中应注意外伤性脑梗塞发生和发展,早期诊断及治疗可能有利于降低脑梗患者的致残率。Objective To investigate the clinical character and the prevention and treatment of traumatic cerebral infarction （TCI）. Methods A retrospective analysis was conducted on the clinical data of 51 patients with traumatic cerebral infraction, including diagnosis, therapeutic method and outcome. Results Of 51 cases, 34 underwent surgical management, including clearance of hematoma by craniotomy with bone flap, brain contusion and laceration management and decompressive craniectomy. Seven cases were undertaken second operation. Twenty-two patients gained good recovery, 7 cases died. Nine were in moderate disability, 7 were in severe disability, 6 were in persistent vegetative state, according GOS classification in two-year of follow-up. Conclusion The clinicians should pay attention to the prevention and therapy of traumatic cerebral infarction. Early prevention and treatment are essential for reducing mortality and morbidity of patients with traumatic cerebral infarction.

关 键 词：颅脑外伤 脑梗塞 治疗 体会 

分 类 号：R651[医药卫生—外科学]