首诊轻型颅脑损伤伤情恶化41例临床分析

目的 分析总结首诊为轻型颅脑损伤病情恶化的临床特点。方法回顾性分析我科1999年12月～2003年1月间收住的41例轻型颅脑损伤病人病情恶化即出现昏迷或手术治疗的临床资料。结果本组病情恶化原因为颅内创伤性病变形成，硬膜外血肿占首位(46．3％)，其次为脑挫伤及脑内血肿(29．2％)，硬膜下血肿119．5％)。32例恶化发生在伤后24小时内，36例病人需手术治疗。按GOS标准评定，本组27例恢复良好，6例中残，3例重残，1例植物生存，死亡2例，自动出院2例。结论尽早完善检查，明确诊断，严密动态观察病情变化，掌握手术指征，及时手术治疗处理继发性损伤，是防治轻型颅脑损伤伤情恶化的关健。

Clinical analysis of the deterioration of patients diagnosed initially as mild head injury in 41 cases

Objective To analyze the clinical features of the deterioration of patients diagnosed primarily as mild head injury.Methods Retrospective analysis of the clinical materials about the deterioration of 41patients treated in our hospital from December 1999 to January 2003.Results The deterioration was caused by the following pathological changes: extradural hematoma 46.3%,brain contusion and intracranial hematoma 29.2%,subdural hematoma 19.5%.Thirty-two of them suffered the deterioration 24 hours after injury and 36 patients needed operation.According to the GOS standards,27 cases recovered well,6 cases were mildly disabled and 3 cases were severely crippled,1 cases became vegetable,2 cases died.Conclusion The key to prevent the deterioration is timely examination,appropriate treatment of secondary injury and accurate diagnosis.