合并脑内血肿的颅脑损伤患者的治疗及预后因素分析

目的 探讨分析创伤性脑内血肿的病理特点、治疗方案和预后因素。方法 对138例患者进行临床研究，全组均行CT扫描。GCS3－14，平均9．5，其中对89例（64．49％）行开颅血肿清除或加去骨瓣减压，并给予亚低温及对症治疗。结果 按GOS评价，恢复良好80例（57．97％），中残27例（19．56％），重残12例（8．7％）,死亡19例（13．77％）。结论 对合并创伤发性脑内血肿颅脑伤伤员的治疗应根据血肿大小、部位和伤情选择治疗方法，其中血肿部位对伤员预后有重要影响。

Treatment and prognostic analysis on head injury associated with intracerebral hematoma

Objective To study the pathological characteristics, choice of treatment strategy and prognostic factors. Methods hundred and thirty-eight patients with Glasgow Coma Scale(GCS) 3-14 (mean 9. 5 ) were involved in this study. Evacuation of the hemotomas or decompressive surgery were done in 89 (64 . 49% ) patients. Moderate hypothermia was used in patients with severe brain contusion. Results According to Glasgow Outcome Scale (GOS) , good in 80 (57 97% ) , moderate disablement in 27 (19. 56% ) , severe disablement in 12 (8. 7% ) and death in 19 (13. 77% ). Conclusion The strategy choice for treating head in injury associated with traumatic intracerebral hemotomas should base on the size.location of the hematomas and the degree of brain injury. The hemotoma location is a key point in the patient prognosis.