浅谈颅脑外伤并发脑梗死的临床治疗

Discussed shallowly the skull flesh wound concurrent brain stem dies clinical treatment

目的：如何针对颅脑外伤并发脑梗死的发病机制进行诊断、治疗和预防.方法：对经头颅CT、MRI证实为颅脑外伤并发脑梗死的28例病例进行临床分析,16例进行开颅手术归为治疗组,其中9例去骨瓣减压,4例内减压,3例开颅清除血肿减压,其余12例均进行保守治疗为对照组,进行脱水、扩张脑血管、营养脑细胞、抗凝,使用钙离子拮抗剂以及低分子右旋糖苷等综合治疗.结果：根据GOS判断预后标准,开颅手术的16例中有8例症状完全消失,5例CT检查有明显改善,2例患者症状无改善,1例死亡.采用综合保守治疗的12例患者中,2例通过头颅CT检查有所改善;6例检查无改善症状（包括2例进入昏迷偏瘫状况）;1例植物生存;3例死亡,无人治愈.结论：及早对颅脑外伤并发脑梗死患者作出正确的诊断进行治疗,可以有效的提高颅脑外伤并发脑梗死的治愈率,同时早期预防也是重要的保证生存质量的因素.

Objective： How aims at the pathogenesis which the skull flesh wound concurrent brain stem dies to carry on the diagnosis, the treatment and the prevention. Methods：To passes through head CT,the MRI confirmation 28 example case of illness which dies for the skull flesh wound concurrent brain stem carries on the clinical analysis, 16 examples carry on the skull surgery to converge the treatment group, 9 example boning petal reduced pressure, in 4 examples the reduced pressure, 3 examples operate the skull to eliminate the haematoma reduced pressure, other 12 examples carry on the conservative treatment are the control groups, carries on the dehydration, the expansion blood vessel of brain, the nutrition brain cell, the antifreeze, the use calcium ion antagonist compound as well as the low molecular dextrose glucoside and so on the complex therapy. Results： According to the CK）S judgment prognosis standard, holds the skull surgery in 16 to have 8 example symptoms to vanish completely, 5 example CT inspection has the distinct improvement, 2 example patient symptom does not have the improvement, 1 example death. Uses the synthesis conservative treatment in 12 example patients, 2 examples have the improvement through the head CT inspection;6 examples inspect the non--improvement symptom （to enter stupor hemiparalysis condition including 2 examples） ;1 example plant survival; 3 example deaths, nobody cure. Coneluslon： Early makes the correct diagnosis to the skull flesh wound concurrent brain stem dead patient to carry on the treatment,may effective the cure rate which enhances the skull flesh wound concurrent brain stem to die, simultaneously the early prevention also is the important guarantee survival quality factor.