急性创伤性弥漫性脑肿胀34例临床分析

Clinical Analysis of 34 Cases of Diffuse Traumatic Brain Swelling

报告34例创伤性弥漫性脑肿胀(TDBS),占我院同期重型脑外伤的9.2％,其发生与原发性损伤程度无关,诊断主要依据CT扫描,其特征为侧脑室、Ⅲ脑室和基底池受压、消失。本组病死率为67.7％,是重型脑外伤死亡的主要原因之一。讨论分析了发病机理、临床表现和治疗方法,对重型TDBS尚无有效的治疗,其预后与伤后意识状况、颅内压和治疗是否合理有关。

Thirty-four cases of diffuse traumatic brain swelling (DTBS) were reported. It was composed 9.2% of all severe injuries, DTBS had no relevance to the state of original injuries. The diagnosis was based on CT scanning, of which the characteristics were the collapse and disappearance of lateral ventrical, third ventric'al of cerebrum and basal cistern. Of the 34 cases, 15 were bilateral, and 19 unilateral. Twenty-three cases were treated without operation, and 11 cases with operation. The mortality was 67.7%. DTBS is a main cause of death from severe brain traumas. The pathological mechanism, clinical manifestation and treatment were discussed. For now, there was no effective treatment for severe acute DTBS. The prognosis was related to the state of consciousness after injury, intracranial pressure, and whether the treatment was in time and reasonable.