外伤性额叶损伤的临床特点与治疗

目的：探讨外伤性额叶损伤的临床特点与治疗。方法回顾性分析2010年2月～2012年10月收治的42例外伤性额叶损伤患者的临床资料，分析其临床特点和诊治方法。结果42例患者经治疗后共死亡8例，死亡率19.05%。格拉斯哥预后分级（GOS）评分评价，手术治疗组28例，Ⅴ级（死亡）4例（14.29%），Ⅳ级（持续植物生存状态）5例（17.86%），Ⅲ级（中残）3例（10.71%），Ⅱ级（轻残）5例（17.86%），Ⅰ级（良好）11例（39.29%）。保守治疗组14例，Ⅴ级（死亡）4例（28.57%），Ⅲ级（中残）1例（7.14%），Ⅰ级（良好）9例（50.00%）。结论外伤性额叶损伤早期症状并不严重，但部分病情发展比较复杂，特别是额叶解剖位置特殊，易进展为枕骨大孔疝等严重病症，应把握手术时机及时救治，保守治疗者应密切监视患者体征及CT动态变化。

The clinical characteristics and treatment of traumatic frontal lobe injury

Objective To explore the clinical characteristics and treatment of traumatic frontal lobe injury. Methods The clinical data of 42 patients with traumatic frontal lobe injury were chosen for a retrospective analysis from February 2010 to October 2012, then figure out the clinical characteristics of traumatic frontal lobe injury and treatment methods. Results After treatment, 8 cases died among 42 patients. The mortality rate was 19.05%. Due to Clasgow outcome score（GOS）, 28 cases of operation treatment group were in different level, such as , levelⅤ（death）：4 cases（14.29%）;Ⅳ（continuous plant survival）：5 cases（17.86%）;Ⅲ（residue）：3 cases（10.71%）;Ⅱ（light）：5 cases（17.86%）;levelⅠ（good）：11 cases（39.29%）, while in the conservative treatment group, among 14 cases, 4 cases（28.57%）were at Ⅴlevel（death）, 1 case（7.14%）at Ⅲ（residue）, 9 cases（50.00%）at Ⅰ（good）. Conclusion Traumatic frontal lobe injury early symptoms were not serious, but some patients’illness development was more complex. Because the special location of the frontal anatomical, Traumatic frontal lobe injury would easily develop into serious condition, like foramen magnum hernia. Doctor should grasp the operation time timely, and keep an eye on the patients in conservative treatment group, and check the patients＆#39; symptoms and CT dynamic change anytime.