外伤性急性脑肿胀CT分型与临床治疗探讨

The CT Typing and Clinical Therapeutic Study for Post-traumatic Acute Brain Swelling

目的探讨外伤性急性脑肿胀患者的CT分型及治疗方法。方法对72例外伤性急性脑肿胀患者,根据其24h内CT征象中线结构是否移位>5mm为标准,分为A、B、C三组:一侧半球脑肿胀,但中线移位≤5mm为A组;中线移位>5mm为B组;双侧半球弥漫性脑肿胀,不论中线是否移位为C组,分析治疗效果。结果A、B和C三组患者手术生存率分别是78.6%、76.2%和40.0%。A、B组和C组比较差异有统计学意义(P<0.05);A、B组手术与非手术生存率为77.1%和38.4%(P<0.05);C组手术与非手术生存率为40%和33.3%,差异无统计学意义(P>0.05)。结论根据CT分型选择不同的治疗方式及恰当的手术时机是提高TABS生存率的关键。

Objective To investigate the CT typing and therapeutic measures of traumatic acute brain swelling（TABS）.Methods Clinical efficiency was studied,72 cases with TABS were divided into 3 group based on CT scanning middle line shift more or less than 5 mm within 24 hours：Hemisphere brain swelling plus middle line shift less than 5 mm（group A）,middle line shift more than 5 mm（group B）,and bilateral brain swelling（group C,despite of shift）.Results The post-operation survival rates of group A,B and group C were78.6%,76.2% and 40% respectively.There was a very significant difference between group A,B and group C（P〈0.05）.The group A,B survival rates of operation and non-operation were 77.1% and 38.4% respectively（P〈0.05）,while the survival rates of operation and non-operation of group C were 40.0% and 33.3%,the difference was not significant（P〉0.05）.Conclusion To select difference measures according to the CT typing and appropriate operational occasion were key to reduce the mortality of TABS.