原发性脑干损伤52例临床分析

Clinical Analysis on Primary Brain Stem Injuries of 52 Cases

目的探讨原发性脑干损伤的治疗方法与效果。方法对我院2000年以来的52例原发性脑干损伤的治疗与效果进行总结分析。其中18例有手术指征的急诊行开颅血肿清除去大骨瓣减压术,给予保持呼吸道通畅、亚低温、脱水、抗感染、钙拮抗剂、高压氧等综合治疗。结果死亡13例(25.0%);植物生存4例(7.7%),重残8例(15.4%),轻残12例(23.1%),恢复良好15例(28.8%)。13例死亡病人中,入院时GCS 3分者7例,4分者3例,5分者2例,8分者1例。结论及时手术、保持呼吸道通畅、亚低温、脱水、抗感染、钙拮抗剂、高压氧等综合治疗可明显降低原发性脑干损伤的死残率。

Objective To explore the therapeutic approaches to primary traumatic injury in the brain stem and observe their effecf on it. Methods An analysis of therapeutic effect was carried out in 52 cases of primary injurey of brain stem since the year of 2000. Among them, 18 eases were dealed with emergency surgery by hematoma clearance and decompression via craniotomy in addition to synthetical therapy such as maitainning expedite airway, sub-hypothermia, dehydration, anti - bacterial, Ca2, ＋ antagonist, hyperbaric oxygenation, etc. Results Death occurred in 13 eases （25.0%）. Four cases （7.7%） lapsed into vegetative state, eight eases （15.4%） into severely disabled state, and 12 eases （23.1%） into moderately disabled state. Fifteer： eases （ 28.8% ） enjoyed a favorable recovery. Among the 13 death cases, seven had a Glasgow Coma Score （GCS） of 3, three a GCS ot 4, two a GCS of 5, and one a GCS score of 8. Conclusion Synthetical therapy, such as emergency surgery, maitainning expedite airway, sub-hypothermia, dehydration, ant-bacterial, Ca2 ＋ antagonist, hyperbaric oxygenation, ere, can immensely reduce the mortality and disability rate of the patients with primary injury of brain stem.