重型额叶脑挫裂伤30例临床分析

Clinical Analysis on 30 Cases of Severe Contusion and Laceration of Frontal Lobe

目的总结重型额叶脑挫裂的临床特点和治疗经验。方法对30例重型额叶脑挫裂伤临床资料进行回顾性分析。结果30例患者中,14例急诊手术;16例早期非手术观察治疗患者,6例GCS5～8分患者后期转手术治疗。根据GOS预后评分,良好20例(66.67%),中残5例(16.67%),重残3例(10.0%),死亡2例(6.66%)。结论对重型额叶脑挫裂伤患者,临床上应密切观察病情变化,动态观测颅脑CT改变,尽早进行综合治疗,有手术指征时即刻手术,才能有效提高治愈率,降低死残率。

Objective To summarize the clinical characters and experiences of the severe contusion and laceration of frontal lobe. Methods The clinical data of 30 cases with severe contusion and laceration of frontal lobe were analyze retrospectively. Results 14 cases underwent emergency operations;16 cases underwent early non-operative observation and treatment,in which 6 cases with Glasgow Coma Scale（GCS） 5 to 8 scores were changed into surgery. According to GOS classification,20 cases gained the excellent recovered（66.67% ） ,5 cases were suffered moderate disability（ 16.67% ） ,3 cases got severe disability（ 10.0% ） , 2 cases died（6.66% ）. Conclusion The close clinical observation of the changes of illness state, dynamic monitoring the imaging of cerebral CT,and early comprehensive treatment should be performed in patients with severe contusion and laceration of frontal lobe. The timely surgical treatment can increase the curative rate and decrease mortality and disability rate.