外伤性急性弥漫性脑肿胀的临床分型及治疗  

Clinical classification and treatment of traumatic acute diffuse brain swelling

作　　者：郝学红[1] 张强[1] 

机构地区：[1]青海省人民医院神经外科,西宁810007

出　　处：《中国实用神经疾病杂志》2014年第13期3-5,共3页Chinese Journal of Practical Nervous Diseases

基　　金：青海省科学技术厅2013年第一批基本科技计划项目(项目编号:2013-Z-918)

摘　　要：目的：探讨外伤性急性弥漫性脑肿胀的临床分型方法以及治疗方案。方法回顾性分析我院急诊于2002-04-2012-09收治的152例外伤性急性弥漫性脑肿胀患者的临床资料，总结本病的临床分型方法与治疗方案。结果（1）保守治疗的有效率为61.54％，手术治疗的有效率为64.86％，两者相比较差异无统计学意义（P＞0.05）。（2）GCS评分≤3分的患者有效率为13.64％，GCS评分4～6分的患者有效率43.75％，GCS评分＞6～8分的患者有效率为47.73％，GCS评分8～12分的患者有效率为88.89％，组间比较差异具有统计学意义（ P＜0.05）。结论影响本病预后的主要原因为术前GCS评分，评分越高预后越好。同时可根据中线有无明显移位对本病进行临床分型，分别给予保守治疗与手术治疗，方可取得较好的临床效果。Objective To investigate classification methods as well as the clinical treatment programs for the traumatic a-cute diffuse brain swelling .Methods A retrospective analysis of the data of 152 patients with traumatic acute diffuse brain swelling admitted to our hospital＇s emergency room from April 2002 to September 2012 were made ,the treatment process of these cases was analyzed ,the clinical classification of the disease and methods treatment programs were summarized .Results①The effective rate of conservative treatment was 61 .54% ,and that of surgical treatment was 64 .86% ,there was no signifi-cant difference between the two groups （ P〉 0 .05 ） . ② The effective rate of patients with GCS score ≤ 3 was 13 .64% ,that of patients with GCS score at 4-6 was 43 .75% ,that at 6-8 score 47 .73% ,that at 8-12 score 88 .89% ,the difference between any two groups was statistically significant （P 〈0 .05） .Conclu-sion The main reason for the prognosis of the disease is the preoperative GCS score ,the higher the score the better the prog-nosis .While according to whether the midline shift is apparent ,the clinical classification of the disease can be made ,the con-servative treatment or surgical treatment was determined to give in order to obtain better clinical results .

关 键 词：外伤性急性弥漫性脑肿胀 临床分型 颅脑外伤 

分 类 号：R651.15[医药卫生—外科学]