中重度颅脑损伤后脑梗死分型的初步探讨  

A preliminary study on the classification of cerebral infarction after moderate to severe craniocerebral injury

作　　者：赵鹏[1] 施正生[1] 陈新生[1] 张林[1] 

机构地区：[1]安徽医科大学附属安庆医院神经外科,246004

出　　处：《中华神经外科杂志》2015年第10期1037-1041,共5页Chinese Journal of Neurosurgery

摘　　要：目的探讨中、重度颅脑损伤后各种脑梗死的分型方法，进行经验总结。方法对2011年6月至2013年6月安徽医科大学附属安庆医院神经外科收治的中、重度颅脑损伤患者进行回顾性分析。依据脑梗死患者的影像学资料、梗死区供血血管位置以及发生脑梗死后所采取的针对性治疗措施，对中、重度颅脑损伤后各种脑梗死予以总结、归类并分型。结果共纳入206例中、重度颅脑损伤患者，其中33例（16％）发生脑梗死，共计45处梗死灶。将各种脑梗死归类后分为四型：领域型脑梗死（梗死灶21处，占47％）、分水岭型脑梗死（梗死灶10处，占22％），血管末梢型脑梗死（梗死灶5处，占11％），创伤周边型脑梗死（梗死灶9处，占20％）。结论中、重度颅脑损伤后脑梗死的四型分类法对创伤后脑梗死的临床诊断、治疗和研究有一定的指导意义。Objectives To investigate the classification methods of various cerebral infarctions after moderate to severe craniocerebral injury and to summarize the experiences. Methods The patients with moderate to severe craniocerebral injury admitted at Department of Neurosurgery, Affiliated Anqing Hospital of Anhui Medical University from June 2011 to June 2013 were analyzed retrospectively. According to the imaging data, the site of cerebral infarction, as well as the targeted treatment measures taken after cerebral infarction, a variety of cerebral infarctions after moderate to severe brain injury were summarized and classified. Results A total of 206 patients with moderate to severe craniocerebral injury were collected and documented, 33 （ 16% ） of them had cerebral infarction and a total of 45 infarct loci were found. The various cerebral infarctions were classified into four types： 21 （47%） territorial cerebral infarctions, 10 （22%） watershed cerebral infarctions, 5 （ 11% ） peripheral vascular cerebral infarctions, and 9 （20%） traumatized peripheral cerebral infarctions. Conclusions In the four types of cerebral infarction, their imaging findings, risk factors, and treatment options are different. After moderate to severe craniocerebral injury, the 4-type classifications of cerebral infarction have certain guiding significance for clinical diagnosis, treatment and study of cerebral infarction after trauma.

关 键 词：颅脑损伤 脑梗死 分类法 

分 类 号：R651.15[医药卫生—外科学] R743.3[医药卫生—临床医学]