重型颅脑损伤与继发性脑梗死的预防及治疗

Severe traumatic brain injury and its secondary cerebral infarction

目的分析重型颅脑损伤继发脑梗死的原因,探讨重型颅脑损伤继发脑梗死的预防及治疗。方法回顾我院1996 -2004年收治的重型颅脑损伤病人在救治中继发脑梗死的临床特点及预后。结果 480例重型颅脑损伤的病人继发脑梗死42例, 继发脑梗死的发生率占8．8％,其中成人组432例发生脑梗死34例,占7．9％;儿童组病例48例,发生继发脑梗死8例,占 17％。儿童组病例继发脑梗死的例数明显高于成人组。结论重型颅脑损伤病人由于脑损伤的病理生理过程继发脑梗死外,在治疗过程中一些治疗因素也可引发脑梗死。脑梗死的发生加重脑组织的损伤,影响预后。

Objective To analyze the causes of the secondary cerebral infarction in severe traumatic brain injury and study the prevention and treatment for such secondary cerebral infarction. Methods Resulting from the severe traumatic brain iniury, patients hospitalizing in our hospital from 1996 to 2004, the clinical features and prognosis in the treatment of the secondary cerebral infarction, were reviewed. Results For a total of 480 cases of patients with severe traumatic brain injury, 42 eases had secondary cerebral infarction, covering 8.7 % of the total cases in this group, in which 432 cases were adult with secondary cerebral infarction of 34 cases covering 7.8 % and 48 cases were children with secondary cerebral infarction of 8 cases covering 17 % o The incidence of the secondary cerebral infarction in children was much higher than that in adult. Conclusion The physiopathologic process and some treatment factors may cause secondary cerebral infarction. The incidence of cerebral infarction would accelerate the injury of the brain tissue and affect the prognosis.