重型颅脑损伤合并脑疝及弥散性血管内凝血的诊治分析

Severe traumatic brain injury combined with cerebral hernia and disseminated intravascular coagulation: diagnosis and treatment

目的总结颅脑损伤合并脑疝及弥散性血管内凝血(disseminated intravascular coagulation,DIC)患者的诊治经验,为临床实践提供参考。方法收集本院2013年3月至2014年3月期间重型颅脑损伤101例患者,其中出现脑疝及DIC的病例共9例,回顾分析诊治经过。结果本组9例重型颅脑损伤合并脑疝及DIC,经手术后治愈0例,好转1例,植物生存2例,死亡6例,死亡率约66.7%。结论重型颅脑损伤患者合并脑疝及DIC死亡率极高,在围手术期更快纠正DIC、更安全有效进行手术治疗,配合术后亚低温治疗,以降低患者的死亡率。

Objective To summarize the experience in treating patients with severe traumatic brain injury combined with cerebral hernia and disseminated intravascular coagulation (dic).Method in 101 cases of severe traumatic brain injury from may 2013 to may 2014, 9 cases with cerebral hernia and dic were selected, which were retrospectively analysed and summarized.Resultnone of the 9 cases was cured, among which the condition of 1 patient improved;2 patients presented plant survival status, while 6 patients died after operation and the mortality was about 66.7%.Conclusion The death rate in patients with severe traumatic brain injury combined with cerebral hernia and dic is obviously high.it is proved that correcting dic with faster speed perioperatively,and operating more safely and effectively cooperated with postoperative hypothermia treatment may be beneficial to reduce the patient's mortality.