弥漫性轴索损伤的治疗

Clinical Treatment of Diffuse Axonal Injuries

目的：探讨手术及保守治疗弥漫性轴索损伤（DAI）的临床疗效。方法：对我科1997年1月-2006年1月收治的123例DAI患者的临床资料进行分析。结果：痊愈67例，好转5例．明显好转8例．无改善8例．死亡占28.5％（35／123）GCS≤5分的死亡率为48．0％（23／50）。结论：DAI的诊断主要根据其临床表现结合CT、MRI资料；治疗上宜采用综合治疗。早期应用亚低温和纳洛酮联合治疗能提高疗效。

Objective： To investigate the clinical oulcorne of diffuse axonal injury（DAI）treated with surgery and medication. Methods： The clinical data of 123 cases with DAI were analyzed, who were admitted to the emergency center of brain injury from1997.1 to 2006.1. Resuhs： The completer recovery in 67 cases,recurrence in 5 cases,good recovery in 8 cases,no changed in 8 eases. The general mortalily of this group was 28.5 % （35/123）, but the mortality of those with GCS≤5 on admission was 46.0% （23/50）. Conclusion： The diagnosis of DAI is mainly based on the clinical appearance and the imaging findings,comprehensive interventions should be applied to the treatment of DAI ,and the outcomes will be better if patients receive mild hypothermia and naloxone combine therapy therapy at the early stage of DAI.