脑挫裂伤的环池及中脑改变与预后

目的探讨脑挫裂伤后CT扫描征象中环池、中脑受压程度与患者意识和预后的关系。方法回顾分析1999年2月至2006年6月临床和CT资料完整的脑挫裂伤患者169例，依据伤后首次CT扫描的环池、中脑受压情况，与伤后意识和转归进行统计学处理。结果死亡39例，病死率23．1％。其中27例术后由于脑干、丘脑功能衰竭死亡；8例伤后并发肺部感染、高热、上消化道出血死亡；4例减压术后脑内迟发性出血再次开颅术后死亡。结论观察伤后环池及中脑的形态改变不仅能够了解脑挫裂伤或脑组织肿胀挤压中线结构对中脑损害的动态演变过程，而且还能帮助临床医师评估患者的预后、选择治疗方法及评估治疗措施是否有效。

Changes of cisterna ambiens and midbrain and prognosis in contusion and laceration of brain

Objective To discuss changes of cisterna ambiens and midbrain and prognosis of contusion and laceration of brain. Methods We retrospectively analyzed 169 traumatic patients from February 1999 to June 2006. Results Thirty-nine patients were dead and the fatality rate was 23. 1% (39/169). 27 cases died of nonfunction of brain stem and thalamencephalon; 8 cases died of pulmonary infection, hyperthermy and upper gastrointestinal hemorrhage, and 4 cases died after craniotomy again due to delayed hemorrhage. Conclusion The morphologic changes of cistema ambiens and midbrain can not only show the kinetic process of contusion and laceration of brain, but also help evaluate prognosis.