双额叶重度脑挫裂伤并发中央型脑疝的早期救治观察和预后分析

目的：探讨双额叶重度脑挫裂伤并发中央型脑疝的早期治疗效果。方法选取双额叶重度脑挫裂伤并发中央型脑疝患者54例，采用随机数字表法分为观察组和对照组，观察组采用早期手术治疗，对照组则不接受手术治疗。比较两组临床疗效及预后。结果经过治疗后，观察组GCS评分（12．98±3．85）分，显著高于对照组的（11．35±4．12）分（t＝2．354，P＜0．05），观察组ICU时间及总入院时间明显短于对照组（t＝10．007，P＜0．01；t＝19．278，P＜0．01）；观察组恢复良好率（40．74％）显著高于对照组（14．81％）（χ2＝4.523，P＜0．05），观察组中残率、重残率、植物生存率及病死率（33．33％、14．81％、7．41％、3．70％）均低于对照组（44．44％、22．22％、11．11％、7．41％），但差异均无统计学意义（χ2＝2．587、2．135、2．268、2．189，均P＞0.05）。结论对双额叶重度脑挫裂伤并发中央型脑疝患者进行早期诊断，采用手术治疗方法进行开颅减压，能明显提高治愈率，有效改善预后。

Early treatment of central herniation observation and prognosis of dual frontal concurrent severe cerebral contusion

Objective To investigate the bilateral frontal cerebral contusion complicated by severe central herniation early treatment .Methods 54 cases of severe bilateral frontal cerebral contusion complicated by central herniation patients were randomly divided into the observation group and control group using number table .The obser-vation group were taken the early surgical treatment and the control group were not underwent surgery .The clinical symptoms and prognosis of treatment were compared .Results After treatment ,the GCS score of the observation group was （12.98 ±3.85）,which was higher than （11.35 ±4.12） of the control group（t=2.354,P〈0.05）,and the total time of the observation group ICU hospitalization time was significantly lower than the control group （t=10.007,P〈0.01;t=19.278,P〈0.01）;The good recovery rate of the observation group （40.74%） was higher than the control group（14.81%）（χ2 =4.523,P〈0.05）,the residual rate of the observation group ,severe disability rate,plant sur-vival and mortality （33.33%,14.81%,7.41%,3.70%） were lower than that of the control group （44.44%, 22.22%,11.11%,7.41%）,but the difference was not significant between the two groups （χ2 =2.587,2.135, 2.268,2.189,all P〉0.05）.Conclusion Dual frontal severe brain injury complicated by central herniation patients with early diagnosis and surgical treatment method using craniotomy decompression can significantly improve the cure rate and effectively improve the prognosis of patients with treatment .