双侧额叶脑挫裂伤40例治疗分析

目的 分析双侧额叶脑挫裂伤的临床特点及治疗效果.方法 回顾性分析40例双侧额叶脑挫裂伤患者的临床资料,其中27例患者先行保守治疗,其中中转开颅手术9例;直接行急诊开颅手术治疗13例.分析比较两者病死率差异及随访GOS评分情况.结果 保守治疗转手术治疗9例中,死亡4例(44.4％);直接手术治疗13例中,死亡4例(30.8％),两者病死率差异无统计学意义(x2=0.135,P＞0.05).术后半年GOS评分:良好19例(47.5％),中残9例(22.5％),重残及植物生存4例(10.0％).结论 双侧额叶脑挫裂伤病情复杂,在不确定的情况下可适当扩大手术适应范围,最大程度的改善患者预后.

The clinical analysis of 40 patients with contusion and laceration of the brain in two side of frontal lobe

Objective To explore the clinical characteristice and treatment effect ot contusion and laceration of the brain in two side of frontal lobe. Methods The clinical data of 40 cases were analyzed respectively ,27 cases given conservative treatment according to disease at first, and given skull opened surgery 9 eases;13 cases were given skull opened surgery directly. The death rate and GOS score between the two groups were compared. Results The death rate of patients that converted to skull opened surgery was 44.4% （4/9） , and the death rate of patients that given skull opened surgery directly was 30.8 % （4/13 ）, there was no significant difference （ χ2 = 0.135, P 〉 0.05 ）. GOS of half a year showed good 19 cases（47.5% ） ,deformity of moderate degree was 9 cases（22.5% ） ,the deformity of serious degree was 4 cases（ 10.0% ）. Conclusion The disease of contusion and laceration of the brain in two side of frontal lobe was complicated, so it may expand surgery scope properly at unsure condition, to aim of making prognosis turn good at best.