外伤性脑肿胀的临床研究

Clinical Study of Traumatic Brain Swelling

本研究的目的在于探讨外伤性脑肿胀的临床特征、临床分类和病理生理基础。将３４例此类患者分为致死组和非致死组，并进行ＣＴ、颅内压（ＩＣＰ）、动脉血压（ＡＢＰ）、脑灌注压（ＣＰＰ）、脑血流（ＣＢＦ）、脑氧代谢率（ＣＭＲＯ２）和脑动静脉氧差（ＡＶＤＯ２）检查和测定。结果显示致死组患者有明显脑受压，中线移位，ＣＴ值低，ＩＣＰ升高，ＣＰＰ、ＣＢＦ、ＣＭＲＯ２、ＡＶＤＯ２降低，与非致死组比较，差异有显著性。说明脑血容量和脑水含量增加引起的严重脑缺血可能是致死性脑肿胀的主要病理生理基础之一。

The aim ofthis study was to investigate the clinical feature, category and pathophysiological basis in traumatic brain swelling.Thirty-four cases of brain swelling were divided into fatal and nonfatal series.CT scan, ICP,ABP, CPP, CBF, CMRO2 and AVDO2were measured in those patients who were treated by evacuation of intracranial hematoma or diminution of ICP. Longer-time braincompression,obevious midline shift,lower CT value, higher ICP, and lower CPP, CBF, CMRo2,AVDO2 were observed in the fatalswelling series. There were the statistically significant differences between the two series, It was suggested that severe cerebral is-chemia caused by both increased blood volume and increased water content was the major pathophysiological basis in the fatalswelling.