额叶挫裂伤急性期救治特点的临床分析

目的 探讨额叶挫裂伤急性期的临床特点及其治疗方法 . 方法 对德阳市第二人民医院神经外科自2001年1月至2007年12月间收治的69例额叶脑挫裂伤患者进行资料总结,回顾性分析其临床症状、影像学特征及治疗方法 .结果 本组患者经手术或保守治疗后均痊愈出院,遗留记忆力、认知等功能缺陷6例,部分运动性失语3例.均在后期随访中得到改善或者恢复.治疗期间患者精神症状多见.尤其是双侧额叶脑挫裂伤患者中最为常见,易与病情变化相互混淆. 结论 额叶挫裂伤患者病情变化快,早期精神症状容易造成I临床误判,应加以重视.密切观察患者意识状况,动态复查CT,慎用镇静剂,提高对额叶挫裂伤的认识,均有助于临床诊治.

Clinical analysis of the management during acute phase of frontal lobe contusion injury

Objective To analyze clinical characteristics and management of 69 patients with frontal lobe contusion. Methods The clinical data including the clinical manifestations, imaging findings and treatment were analyzed retrospectively in 69 patients with frontal lobe contusion injury admitted in our department from 2001 to September 2007. Results After the surgery or conservative treatment, the patients in this group were discharged from the hospital. Six still had defect in memory power, cognitive competence and so on. Three had partly motor aphasia. All of these nine patients got improvements and recovery in the follow-ups. Mental disorders were common in the treatment period, especially in cases with bilateral frontal lobe injuries, which was apt to mix with the change of illness. Conclusion Frontal lobe contusion, often with rapid changes in the disease course, may have silent clinical presentations, and the mental disorders in the early phases easily give rise to misdiagnosis. Dynamic CT scans, caution in the use of sedatives, and close intracerebral pressure monitoring are of clinical importance in the management of frontal lobe contusion injuries.