重型颅脑损伤中晚期脑疝影响外科治疗效果的探讨

目的分析重型颅脑损伤发生中晚期脑疝后的各种资料,探讨提高预后水平的可能性。方法回顾性分析279例因重型颅脑损伤而发生中晚期脑疝的病例,列出最常见的一般性临床资料、体检和影像学结果、外科治疗中所涉及的情况,比照相应的病情转归进行讨论。结果本组全部病例都针对病情施行相应的外科治疗。出院时GOS评分:死亡74例,植物生存16例,重残57例,中残94例,恢复良好38例。结论重型颅脑损伤发生中晚期脑疝后治疗难度大,致残率和死亡率高,影响治疗效果的原因是多重性的。临床上应尽量避免不利因素的发展,才有可能提高预后水平。

Study on surgical treatment of severe head injury with cerebral hernia in medial-late stage

Objective To investigate the data for severe head injury with cerebral hernia in middle-late stage and to discuss the ways how to improve their prognosis.Methods Tow hundred and seventy-nine cases suffered from severe head injury with cerebral hernia in middle-late stage including the general clinical manifestation,physical examination,imaging characteristics and the complexion of surgical treatment were reviewed,and were discussed with comparing the prognosis.Results According to patient's condition the surgical management was performed on every patient.Glasgow outcome score(GOS) showed at discharge: 74 died,vegetative state in 16,severe disability in 57,moderate disability in 94,good recovery in 38.Conclusion The managements of these patients are difficult because the therapy results are influenced by multiple factors.The rates of mortality and morbidity are higher.It might be better to prevent the harmful effects.