枕部着力额颞叶对冲伤63例

Clinical study of the frontal-temporal contrecoup injury after occipital impact

目的探讨枕部着力致额颞叶对冲伤的临床特点和救治经验,以求提高疗效。方法对我科收治的63例枕部着力,额颞叶对冲伤患者的临床特点和救治体会进行回顾性分析。结果全组按Jennet标准分级评定,随诊6个月。手术治疗42例,非手术治疗21例,愈后良好(Ⅴ)37例,轻残(Ⅳ)14例,重残或植物生存(Ⅲ+Ⅱ)4例,死亡(Ⅰ)8例。结论枕部着力致额颞叶对冲伤有病情危重、病情变化快、迟发性昏迷、致死率高等特点,密切观察病情变化,尽早复查头颅CT,及时正确的伤情判断,合理有效的手术是改善患者预后的关键。

Objective To investigate the clinical characteristics and therapeutic measures of frontal- temporal contrecoup injury after occipital impact. Methods The clinical characteristics and therapeutic measures of 63 patients with frontal - temporal contrecoup injury after occipital impact admitted to our department were analyzed retrospectively. Results Of the 63 patients, 42 underwent surgical operation, 21 did not;37 recovered, 14 had slight deformity,4 had severe deformity or stayed in vegetative state, and 8 died. Conclusion The frontal- temporal contreeoup injury after occipital impact has the clinical features of severe and variational pathogenetie condition, tardive coma and high lethality. It is very important to observe the change of illness, take the coronal CT earlier, make the judgement of traumatic condition and perform suitable operation.