62例双侧脑挫裂伤双侧开颅手术治疗分析

Analysis of operation on 62 cases of crashing injury at the bilateral sides of brain

目的:总结62例双侧脑挫裂伤的临床特点、CT检查和手术治疗。方法:对62例双侧脑挫裂伤患者的手术治疗进行回顾性分析。结果:均行CT检查,以额颞叶脑挫裂伤多见,多并发外伤性蛛网膜下腔出血、硬膜下血肿和脑内血肿。病例全部行双侧开颅手术,其中双侧开颅手术手术一次的治愈率、致残率、病死率分别为75.0%、12.5%、12.5%;手术两次的治愈率、致残率、病死率分别为31.6%、21.0%和47.4%。手术一次组的治愈率高于手术两次组、病死率低于手术两次组,有显著性差异(P<0.05),而致残率无显著性差异(P>0.05)。结论:双侧脑挫裂伤有其一定的临床特点,对该病的演变与发展做出早期预判、掌握手术指征,及时行一次性双侧开颅手术治疗是预后的关键。

Objective To summarize the clinical symptoms, CT examinations and operation treatment about 62 cases of crashing injury at the bilateral sides of brain. Methods To retrospectively analyze the operation treatment of the 62 cases.Results Fronto-temporal crashing injury of the brain was most likely manifested through CT examinations, complicated by trauma subarachnoid hemorrhage, subdural hemorrhage and cerebral hemorrhage. This group of cases was all performed by craniotomy at both sides of the brain. Among them health-restoring rate, deformity-causing rate and the rate of death of illness resulting from onetime operation amounted respectively to 75.0%, 12.5% and 12.5%, and from two-time operation was respectively 31.6%, 21.0% and 47.4%. Compared with the rates from two-time operation, health-restoring rates from one-time operation was higher,and rate of death of illness from one time operation was lower. The two rates from one-time operation to two time operation were distinguished remarkably （P〈0.05）,whereas deformity-causing rate owned unremarkable diffence （P〉0.05）. Conclusion Crashing injury at the bilateral sides of brain maintains some certain clinical symptoms, and the key to the prognosis is making prior forecast and judgment and adopting prompt measures against the illness.