重型颅脑损伤后早期精神障碍的临床分析

Clinical Study of Psychotic Disorder after Gravis Type of Craniocerebral Injury

目的:探讨重型颅脑损伤后早期精神障碍临床特征及治疗方法,以提高患者的生活质量。方法:对我院48例重型颅脑损伤后早期精神障碍患者进行回顾性分析,观察精神障碍出现的时间、精神障碍的类型及预后及颅脑损伤的部位与精神障碍的关系。结果:重型颅脑损伤后精神障碍主要出现在伤后3周内,多继发于颞叶损伤,其次为额叶。临床上主要有躁狂型、抑郁型、痴呆型、精神分裂性等四型,其中以躁狂型为多见。通过治疗后,<1个月精神症状痊愈25例、<2个月痊愈13例、治疗>2个月仍有精神症状10例。结论:颅脑损伤后精神障碍在原发脑损伤的有效治疗前提下,辅以抗精神障碍药物治疗、心理治疗及高压氧治疗等可取得较好疗效。

Objective：To analyze clinical feature and treatment of psychotic disorder after severe craniocerebral injury.Methods：Forty-eight cases with psychotic disorder after heavy head injury were retrospectively analyzed.What time mental disorders occurred,type and prognosis of psychotic disorder and the relationship between parts of brain injury and mental disorders were observed.Results：Mental disorders after severe head injury occurred within three weeks.Mental disorders after heavy traumatic brain injury were secondary to multi-temporal lobe injury,followed by frontal lobe injury.There were manic,depressive,dementia and schizophrenia in clinic.The patients of manic were the most.Conclusion：Through treatment of primary disease,antipsychotic treatment,psychological treatment and hyperbaric oxygen treatment,better therapeutic effect can be obtained in mental disorders after heavy head injury.