进行性出血性脑损伤手术时机探讨  

Operation timing of progressive hemorrhagic brain injury

作　　者：刘滨[1] 杨涛[1] 杨波[1] 张义[1] 刘世强[1] 苗露[1] 

机构地区：[1]解放军148医院神经外科,山东淄博255300

出　　处：《创伤外科杂志》2015年第5期407-409,共3页Journal of Traumatic Surgery

摘　　要：目的探讨进行性出血性脑损伤的最佳手术时机,以提高临床治疗成功率,降低致残率及死亡率。方法将148例进行性出血性脑损伤患者根据其手术时机的不同分为观察组（74例）及对照组（74例）。男性79例,女性69例;年龄11～79岁,平均（44.6±8.7）岁。道路交通伤88例,暴力重击伤43例,高处坠落伤17例。观察组患者手术时间至受伤时间〈24h,对照组手术时间至受伤时间〉24h,分析两组患者的临床治疗效果及并发症发生情况。结果观察组患者临床治疗有效率为91.9%,明显高于对照组（79.7%）,具有统计学意义;观察组并发症发生率为6.8%,明显低于对照组（14.9%）,存在统计学差异。结论伤后及时复查颅脑CT,并在24h内实施开颅手术能够有效地提高进行性出血性脑损伤患者的临床治疗有效率,降低并发症的发生率,改善患者预后。Objective To explore the best operation timing in progressive hemorrhagic brain injury in order to improve the success rate of clinical treatment and reduce the morbidity and mortality.Methods Totally 148 pa-tients with progressive hemorrhagic brain injury were included and divided into observation group （74 cases） and control group （74 cases） according to the operation timing.Of the 148 patients,79 were males and 69 were females with the age ranged from 11 to 79 years[mean age（44.6 ±8.7）years].A total of 88 cases were injured by traffic accident,43 cases were injured by violent conflict and 17 cases were injured by falling.The patients in the observa-tion group were operated within 24 hours,while those in the control group were operated after more than 24 hours. The therapeutic efficacy and complications in each group were analyzed.Results The clinical efficacy rate in the observation group was 91.9%,which was significantly higher than that of the control group（79.7%） with statistical significance.In terms of the incidence of complications,the complication rate of the observation group was 6.8%, which was significantly lower than that of the control group（14.9%）,and there were statistical differences.Con-clusion By rechecking craniocerebral CT in time and performing surgical operation within 24 hours,the prognosis and therapeutic efficacy can be improved significantly and the incidence of complications can be reduced in patients with progressive hemorrhagic brain injury.

关 键 词：脑损伤 手术时机 临床疗效 

分 类 号：R651.1[医药卫生—外科学]