中型颅脑损伤患者亚急性期突发脑疝的急救及护理

The first aid and nursing care on sudden brain herniation in patients with noderate craniocerebral injury during subacute stage

目的:总结中型颅脑损伤患者亚急性期突发脑疝的发病原因、临床特点及急救与护理。方法:分析我科1997～2005年间收治的33例中型颅脑损伤患者在亚急性期突发脑疝的病历资料。结果:脑挫裂伤融合形成血肿扩大、脑挫裂伤继发脑水肿加重、迟发性脑内血肿是中型颅脑损伤患者亚急性期突发脑疝的常见原因。本组30例在病情恶化后接受手术治疗。22例术后恢复良好,4例因枕骨大孔疝而死亡。结论:大多数中型颅脑损伤患者亚急性期病情相对平稳,但部分患者突然发生脑疝,导致致残率或死亡率增高。加强观察及护理,早期发现病情变化和及时处理是降低致残率和死亡率的关键。

Objective：To study the pathogenic causes,clinical features,flint aid nursing care on sudden brain herniation in patients with moderate craniocerebral injury during subacute stage.Methods：The clinical data in 33 cases of sudden brain herniation in patients with moderate craniocerebral injury during subacute stage from 1997 to 2005 treated in our department were studied retrospectivelyl.Results：After cerebral contusion,hematoma formation or fusion amplification,cerebral edema exacerbation and delayed intracerebral hematoma formation were the main causes of sudden brain herniation in patients with moderate craniocerebral injury during subacute stage.30 patients in this group received the operative treatment after exacerbation of their state of illness,22 f them recovered well and 4 died of cerebelar tonsillar herniation.Conclusion：The state of illness in most patients with moderate craniocerebral injury during subacute stage is relatively stable,and some patients women and even develop the suddenbrain herniation,which leads to the increase of the icidene of disability and mortality.Strengthening the observation and nursing care on sudden brain herniation in patients with moderate craniocerebral during subacute stnge,discovering the change of state of illness early and treating promptly are the key to lower the incidence of disability and mortality.