弥散性轴索损伤34例临床报道

Report of 34 cases of diffuse axonal injury

目的:探讨脑弥散性轴索损伤(diffuse axonal injury,DAI)的发病机制、诊断、治疗和预后。方法:对34例DAI患者的临床资料进行回顾性分析。结果:34例DAI患者中为交通事故致伤21例,坠落伤10例,其他类型伤3例。伤后6个月,格拉斯哥预后评分(GOS)良好16例,中残10例,重残3例,植物生存3例,死亡2例。结论:DAI受伤机制复杂,以车祸伤、高处坠落伤为主,意识障碍为其典型的临床表现,影像学检查MRI优于CT,临床上采取综合治疗的方法,GCS、昏迷时间越长,预后越差。

Objective：To investigate the pathogenesis, diagnosis, treatment and prognosis of diffuse axonal injury （DAI）. Methods： The clinical data of 34 cases of DAI were analyzed retrospectively. Results： Among the 34 cases of DAI, 21 were due to traffic accidents, 10 to crashing and 3 were caused by other accidents. According to Glasgowcoma score （GCS）, the recovery was good in 16 cases ,moderate disability was observed in 10 cases, severe disability in 3 cases, vegetative state in 3 cases, and mortality in 2 cases. Conclusions：The mechanism of DAI is quite complicated. Traffic accidents and crashing are the major causes. Conscious disturbance is the typical clinical manifestation. MRI is superior to CT in diagnosis of DAI. Comprehensive interventions should be applied in the treatment of DAI. The outcome is closely associated with GCS and coma time.