颅脑创伤后脑血管痉挛的诊断及治疗体会  

The diagnostic and therapeutic experience of cerebral vasospasm after traumatic brain injury

作　　者：张志华[1] 

机构地区：[1]浙江省台州市中医院脑外科,318000

出　　处：《中国医师进修杂志》2014年第17期42-44,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨颅脑创伤患者脑血管痉挛的检测方法及对预后的影响。方法20例颅脑创伤患者接受经颅多普勒超声检查，按照是否满足脑血管痉挛诊断标准分为痉挛组和对照组。结果全部受检者中出现脑血管痉挛7例，未出现脑血管痉挛13例。痉挛组死亡2例，对照组死亡1例，两组病死率比较差异有统计学意义（P〈0．05）。1年后根据格拉斯哥预后量表评分，痉挛组5例患者重残3例，中残1例，恢复良好1例；对照组12例患者重残2例，中残2例，恢复良好8例，两组恢复良好率比较差异有统计学意义（P〈0．05）。结论颅脑创伤患者发生脑血管痉挛后会增加病死率，存活患者中，发生脑血管痉挛的患者功能评价也更差。预防颅脑创伤患者发生脑血管痉挛有着重要的临床意义。Objective To observe the detection methods of cerebral vasospasm after traumatic brain injury and the impact on prognosis. Methods Twenty patients with traumatic brain injury underwent transcranial Doppler ultrasound were divided into cerebral vasospasm group and control group. Results There were 7 patients combined with cerebral vasospasm and l 3 patients without cerebral vasospasm. Two patients died in cerebral vasospasm group and 1 patient died in control group. The fatality rate between two groups had significant difference （P 〈 0.05）. All surviving patients followed up for 1 year after being discharged. According to the Glasgow Outcome Scale, in cerebral vasospasm group, 3 patients were with severe disability, 1 patient was with moderate disability, 1 patient restored good function. In control group, 2 patients were with severe disability, 2 patients were with moderate disability, 8 patients restored good function. The rate of restored good function between two groups had significant differences （P 〈 0.05）. Conclusions Cerebral vasospasm can increase mortality in traumatic brain injury patients, and the functional evaluation in survival patients are even worse. Prevention of cerebral vasospasm after traumatic brain injury has important clinical significance.

关 键 词：颅脑损伤 血管痉挛 颅内 诊断 治疗结果 

分 类 号：R651.15[医药卫生—外科学]