脑弥漫性轴索损伤125例临床分析

目的探讨脑弥漫性轴索损伤的发病机制、临床特点、诊断、治疗和预后。方法回顾性分析125例脑弥漫性轴索损伤患者的临床资料。结果伤后6个月根据格拉斯哥预后分级：恢复良好28例（22．4％）、中残32例（25．6％）、重残30例（24％）、植物生存11例（8．8％）、死亡24例（19．2％）。结论脑弥漫性轴索损伤是重型颅脑损伤患者死亡的主要原因，敛残率高；意识障碍是其典型临床表现。其诊断MRI检查优于CT；大部分采取非手术治疗。格拉斯哥昏迷评分越低，患者昏迷持续时间越长，预后越差。

Retrospective Analysis on 125 Cases of Brain Diffuse Axonal Injury

Objective To study the pathogcncsis , clinical charaeteristies, diagnosis, treatment and prognosis of brain diffuse axonal injury （DAI）. Methods Clinical data of 125 eases of brain DAI were retrospectively analyzed. Results Final outcomes were graded six months later after injury according to Glasgow Coma Scale （GCS） scores ： good recovery in 28 （ 22.4% ） cases, moderate disability in 32 （25.6%） cases, severe disability in 30 （24%） cases, vegetative state in 11 （8.8%） cases and death in 24 （ 19.2% ） cases. Conclusion With high disability rate, brain DAI is the main cause of death in those witb severe head injury. Consciousness disturbance after head injury is its typical clinical presentation. MRI is superior to CT for the diagnosis. Most patients ought to receive conservative therapy. The lower the CCS scores, the longer the persistent time of coma and the poorer the prognosis.