脑挫裂伤患者亚急性期脑疝临床分析

目的探讨脑挫裂伤患者亚急性期突发脑疝的发病原因、临床特点及治疗方法。方法回顾性分析我科1995年1月～2007年9月间收治的27例脑挫裂伤患者在亚急性期突发脑疝的临床资料。结果脑挫裂伤后一周左右继发脑水肿加重、迟发性脑内血肿脑挫裂伤患者亚急性期突发脑疝的常见时间及原因。本组有16例在病情恶化后接受手术治疗,术后死亡2例,持续植物状态2例,重残2例,中残1例,恢复良好9例。保守治疗11例,死亡1例,恢复良好10例。结论外伤后一周左右是大多数脑挫裂伤患者亚急性期发生脑疝的高峰期,及时保守治疗和手术治疗是治疗的有效方法。

Clinical analysis on brain herniation during subacute phase in patients with cerebral contusion

Objective To explore clinical characteristics on brain herniation during subacute phase in patients with cerebral contusion and discuss its pathogenesis and therapy.Method Data were collected from 27 cases of sudden brain herniation during subacute phase in patients with cerebral contusion from Jan.1995 to Sep.2007 retrospectively.Results Secondary cerebral edema in about one week and delayed intracerebral hematomas after cerebral contusion were the main causes of sudden brain herniation during subacute phase in patients with cerebral contusion.16 patients needed operations when deterioration.After operations,2 patients were dead.2 patients were in persistent vegetative state.2 patients were severely disabled.1 patient was moderately disabled.9 patients were in good outecome.Conservative treatment was performed in 11 patients.One patient was dead.10 patients were in good outceme. Conclusions One week or so is the peak period of sudden brain herniation during subacute phase in patients with cerebral contusion.Timely conservative treatment and operation were effective methods.