对冲性前额叶挫裂伤诊治策略

Diagnosis and treatment of contrecoup contusion and laceration in frontal lobe

目的探讨对冲性前额叶挫裂伤的临床特点和治疗策略。方法对48例对冲性额叶脑挫裂伤患者的临床资料进行回顾性分析。结果根据GOS评分：恢复良好36例，中残8例，重残2例，植物生存状态1例，死亡1侧。结论对冲性前额叶底部挫裂伤常合并有枕部硬膜外血肿及弥漫脑肿胀，及时发现枕部迟发性硬膜外血肿，应用标准外伤大骨瓣开颅术治疗重型对冲性脑挫裂伤合并弥漫脑肿胀是提高抢救成功率的关键。

Objective To discuss the clinical characteristics and therapeutic strategy of contrecoup contusion and laceration in frontal lobe. Methods 48 cases with contrecoup contusion and laceration in frontal lobe were ana- lysed retrospectively with their imaging feature. Results In accordance with the GOS,36 cases survived well,8 suffered from moderate disability. One keept in pemistent vegetative state and one was dead. Conclusion Contrecoup contusion and laceration in frontal lobe merged with occipital extradural hematoma and diffuse brain swening. Early di- agnosis and treatment for the ~lelayed occipital extradural hematoma, and standard large trauma craniotomy in treatment of heavy eontrecoup contusion and laceration with diffuse brain swelling in frontal lobe were the key measures to improve the rate of success rescue.