地震伤员中外伤性脑梗死的诊断和治疗：九例分析

目的探讨地震伤员中外伤性脑梗死（TCI）的诊断和治疗。方法对汶川地震伤员2087例的临床资料进行回顾分析。结果2087例地震伤员中有颅脑外伤伤员175例，32例合并高血压病，8例伤员出现TCI，另有1例全身多发骨折的伤员于伤后第2d出现脑梗死。TCI发生率颅脑外伤组为4．57％（8／175），显著高于非颅脑外伤组（1／1912，0．47％，P〈0．01）。颅脑外伤组中8例出现TCI，19例合并蛛网膜下腔出血（SAH），其中TCI发生率为34．84％（7／19），显著高于非SAH颅脑外伤组（0．64％，1／156，P〈0．01）；高血压组TCI发生率（15．62％，5／32）高于非高血压组（2．10％，3／143，P〈0．05）。结论颅脑外伤伤员，尤其是合并SAH和高血压病者，一旦出现新发神经系统相关症状、体征，均应考虑到TCI的可能，并进行早期诊治。

Diagnosis and treatment of traumatic cerebral infarction in persons wounded due to earthquake: analysis of 9 cases

Objective To investigate the diagnosis and treatment of traumatic cerebral infarction （TCI） in persons wounded due to earthquake. Methods The clinical data of 2 087 persons wounded in the Wenchuan Earthquake were analyzed retrospectively. Results Theere were 175 cases of cerebral trauma , 32 cases of hypertension, and 8 cases developed TCI. Another one case with generalized multiple fracture developed TCI one day after the trauma. The TCI rate of the cerebral trauma group was 4.57% （8/175）, significantly higher than that of the non-cerebral trauma group （ 9/1 912, 0.47%, P〈0.01 ）. Nineteen of the cerebral trauma patients were complicated with subarachnoid hemorrhage （ SAH ）, 8 of which developed TCI with a TCI rate of 34.84% （7/19）, significantly higher than that of the non-SAH cerebral trauma patients （0.64%, 1/156, P〈0.01）. The TCI rate of the hypertension patients （15.62%, 5/32） was higher than that of the non-hypertension patients （2.10%, 3/143, P〈0.05）. Cone I us i on Once new symptoms and signs of nervous system were seen in the cerebral trauma patients, especially those with SAH and/or hypertension, the possibility of TCI should be considered. Early diagnosis and treatment are helpful.