交通伤致对冲性侧裂区脑挫裂伤的早期处理

目的 分析交通伤致对冲性侧裂区脑挫裂伤发病机制、早期处理与预后的关系。方法 回顾性分析我科收治的交通伤致对冲性侧裂区脑挫裂伤36例，根据伤情和受伤机制，早期改善呼吸，处理危及生命的合并伤；采用标准外伤大骨瓣开颅术31例，其中双侧开颅术13例，保守治疗的9例中4例病情加重改为手术。结果 死亡8例，植物状态2例，重残2例，中残6例。恢复良好18例。结论 早期综合处理，及时行标准去大骨瓣减压，重视中线结构区周围的脑挫裂伤，加强病情的动态观察和管理，及时采取有效措施，可降低死亡率，改善预后。

Early treatment of sylvian fissure contusion of brain caused by traffic accident

Objective To analyze the relationship of pathogenesis and early management with prognosis of sylvian fissure contusion of brain caused by traffic accident. Methods A review was done on 36 cases with sylvian fissure contusion of brain caused by traffic accident, in which early improvement of respiration and management of combined injuries were performed according to injury severity and pathogenesis. Standard big bone flap craniotomy was done in 31 cases including bilateral craniotomy in 13. Of nine cases treated conservatively, four cases turned to operation due to aggravation. Results Of all, 18 cases recovery better but death occurred in eight, vegetative state in two, bad disability in two and moderate disability in six. Conclusions Early synthetic treatment, prompt decompression with standard big bone flap, paying attention to sylvian fissure contusion in the midline area, dynamic observation of injury and effective treatment can improve prognosis and reduce mortality rate.