颅脑损伤亚急性期病情恶化临床分析

Clinical Study of subacute Deterioration of Head-injured Patients

目的:总结"轻、中"型颅脑损伤患者亚急性期病情恶化的临床特点。方法:回顾性分析创伤亚急性期出现病情恶化的15例"轻、中"型颅脑损伤病例的病历资料。结果:亚急性硬膜下血肿形成、脑挫裂伤继发脑水肿和脑梗塞是颅脑损伤患者亚急性期病情恶化的常见原因,占13例(86.17%);11例(75%)在病情恶化后接受手术治疗,预后良好。1例因继发脑室内出血或枕骨大孔疝而死亡。结论:尽管"轻、中"型颅脑损伤亚急性期病情恶化在临床上相对少见且多数患者预后良好,但仍有部分病例因此而致残或死亡,积极处理并尽可能避免类似情况的发生仍是颅脑损伤临床治疗的重点之一。

Objective： To study the clinical features of ＂mild＂ and ＂moderate＂ head-injured patients worsening clinically during the subacute phase after trauma. Methods： The data of 15 eases of subacute deteriorated head-injured hospitalized in our department were studied retrospectively. Results： Symptomatic suba-cute subdural hematoma , cerebral edema after brain contusion and cerebral-infarction were the main causes of exacerbation during the subaeute phase after trauma. There were 13 eases （86.17%） o There were 11 patients had been treated surgically after exacerbation and had a good prognosis .With 1 case died of intraventricular hemorrhage or cerebellar tonsillar hernia. Conclusion： Though head-injured patients worsening clinically during the subacute phase after trauma are relatively rare , we should do our best in the treatment to avoid such worse results.