额颞对冲性脑损伤并迟发血肿的临床特点及救治措施

目的总结分析额颞部对冲性脑损伤并迟发血肿的临床特点及探讨有效的救治措施。方法对29例额颞颞对冲性脑损伤并迟发血肿患者,采用标准外伤大骨瓣开颅术,术后均入神经外科重症监护,并给予保持呼吸道通畅、脱水、护脑、对症、支持、防治并发症等治疗。结果存活21例,其中良好13例,中残4例,重残4例,死亡8例。结论额颞部对冲性脑损伤并迟发血肿是一种较为危重、复杂的颅脑损伤,及时行标准大骨瓣减压术是救治成功的有效措施。

The Clinical Characteristics and Treatment in Frontotemporal Counter- ecoup Craniocerebral Injury and Delayed Intracanial Hematoma

Objective:To sum up the clinical characteristics of frontotemporal contrecoup craniocerebral injury and delayed intracanial hematoma,and to discuss the effective treatment.Methods:Twenty-nine patients with frontotemporal counter-coup craniocerebral injury and delayed intracanial hematoma were treated by standard craniotomy.All patients were sent to NICU and received general therapy for maintaining a free airway and dehydration therapy.Results:Twenty-one patients were survived,including 13 patients with good recovery,4 with moderate disability,4 with severe disability,and 8 patients died.Conclusions:The frontotemporal counter-coup craniocerebral injury and delayed intracanial hematoma was an urgent and complex brain injury,early standard craniotomy was a good therapeutic method.