外伤后急性弥漫性脑肿胀临床分析(附51例报告)

Clinical analysis of posttraumatic acute diffuse brain swelling (A report of 51 cases)

目的探讨外伤后急性弥漫性脑肿胀的临床特点。方法对51例外伤后急性弥漫性脑肿胀患者的临床资料进行回顾性分析,总结其发病机制、CT的影像学特点,比较各种治疗措施的疗效。结果手术治疗28例,恢复良好5例,死亡18例;保守治疗23例,恢复良好2例,死亡14例。结论外伤后急性弥漫性脑肿胀本身无特异性症状和体征,主要依靠临床经验和头颅CT诊断。采取包括脱水剂、过度换气、大剂量激素、亚低温、支持治疗等综合措施及手术治疗,可以获得较好疗效。

Objective To explore the clinical features of posttraumatic acute diffuse brain swelling （PADBS）. Methods Fifty - one cases of PADBS were analyzed retrospectively and pathogenesis, imaging findings of CT were summarized and effects of treating methods were compared. Results Among 51 cases, 28 patients were treated surgically, and the good recovery was 5, the dead 18, 23 patients were treated nonsurgically, and the good recovery was 2, the dead 14. Conclusion Diagnosis of PADBS depends on clinical experience and CT as it has no special clinical symptoms. Cood effect of treatment could be gained with combination treatments include dehydration, hyperventilation, large dose of hormone, mild hypothermia, sustainment and operation on the appropriate patients.