对冲性额叶脑挫裂伤合并枕骨骨折的临床特点及治疗(附198例报告)  

Characteristics and treatment strategies of frontal lobe brain contrecoup contusion associated with occipital fracture(report of 198 cases)

作　　者：郭洪刚[1] 张法学[1] 孟英[1] 

机构地区：[1]莱芜钢铁集团有限公司医院神经外科,山东271104

出　　处：《中国临床神经外科杂志》2014年第9期527-529,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨对冲性额叶脑挫裂伤合并枕骨骨折的临床特点和治疗方法。方法回顾性分析198例对冲性额叶脑挫裂伤合并枕骨骨折患者的临床资料,其中急诊手术治疗28例,保守治疗170例（因病情变化,在保守治疗过程中改行手术治疗34例）。结果出院后随访6月～12年,按GOS评分评定预后,恢复良好156例,中残13例,重残17例,死亡12例。结论对冲性额叶脑挫裂伤合并枕骨骨折的患者入院后如果病情危重,危及生命,应急诊手术治疗;如意识障碍较轻,可保守治疗,尽可能延期手术,减少迟发性硬膜外血肿的发生。Objective To summarize the clinical manifestations, imaging features, treatment and surgical indications and opportunity of the frontal lobe brain contrecoup contusion associated with occipital fracture（CCAF）.Methods The clinical data of 198 patients with frontal lobe brain CCAF, of whom 28 underwent emergency surgery and 170 were conservatively treated（34 were treate also by surgery because of the poor effects of conservative treatment）, analyzed retrospectively.Results Of 198 patients who wer followed up from 6 months to 12 years, 156 were recovered well, 13 moderately disabled, 17 severely disabled and 12 died.Conclusion The surgery should be performed immediately if the patents with frontal lobe brain CCAF are in critical conditions. The patients with frontal lobe brain CCAF who had mild disturbance of consciousness may be first treated conservatively and if their conditions ar deteriorated, the surgery should be performed also. The incidence of delayed epidural hematoma may be decreased by the delayed surgery in the patients with frontal lobe brain CCAF.

关 键 词：对冲性脑挫裂伤 额叶 枕骨骨折 临床特点 手术 

分 类 号：R651.15[医药卫生—外科学] R651.11[医药卫生—临床医学]