弥漫性轴索损伤36例诊治体会

The understanding of 36 cases of diffuse axonal injury patients' diagnosis and treatment

目的探讨弥漫性轴索伤(diffuse axonal injury,DAI)临床诊断,治疗及预后。方法回顾性分析2006年10月至2010年1月共收治的DAI36例的相关临床资料,CT影像及治疗方法。结果良好18例(占50%),重残11例(占30%),植物生存5例(占14%),死亡2例(占6%)。结论 DAI的病死率及致残率在文献中极高,目前对弥漫性轴索损伤尚无特效药物治疗;但正确诊断,早期气管切开,必要的呼吸机辅助呼吸,大剂量盐酸纳络酮、神经节苷脂GM-1、Ca2+拮抗剂使用,早期营养支持,高压氧治疗等可以改善预后。

Objective To investigate the clinical treatment and prognosis on the diffuse axonal injury（DAI）.Methods Retrospective analysis from October 2006 to January 2010 were admitted to the relevant clinical data DAI 36 cases,research on the 36 DAI patients＇ relevant clinical data /CT imaging and treatment from October 2006 to January 2010 by retrospective analysis.Results Good recovery was in 18 cases（50%）,severe disability was in 11 cases（30%）,vegetative state in 5 cases（14%）,while death in 2 cases（6%）.Conclusion Although the mortality and disability of DAI were high in the literature,there is no effects of diffuse axonal injury there are no specifics in treatment of DAI currently,however,it comes to the understanding that the prognosis of DAI can be improved by a series combined modality therapy,such as correct diagnosis,early tracheotomy,ventilator-assisted breathing for necessary,using high-dose naloxone hydrochlorideGanglioside（GM-1）/Ca2＋ antagonist,early nutritional support,hyperbaric oxygen therapy.