外伤后急性半球脑肿胀的临床分析及预后

Acute posttraumatic cerebral hemispheric swelling

目的探讨外伤后急性半球脑肿胀的临床特点和治疗方法。方法分析57例外伤急性半球脑肿胀的临床表现和治疗结果。手术治疗36例，保守治疗21例。结果按GOS标准，治愈24例（421％），重残3例（5．3％），中残11例（19．3％），植物生存1例（1．8％），死亡18例（31．5％）。结论急性半球脑肿胀多合并有其他类型脑损伤，典型CT表现中线移位程度与颅内血肿厚度不成比例。手术去骨瓣减压、大剂量皮质激素联合甘露醇、早期正确的过度换气为治疗的有效措施。

objective Investigation of the clinical feature and treatment of posttraumatic cerebralhemispheric swelling. Methods 57 cases of posttraumatic cerebral hemispheric swelling were studied;36 patients of them were treated surgically and 2l patients nonsurgically. Results Among 57 cases, thegood recovery was 42. 1 %. mild disability l9. 3%, severe disability 5. 3%, vegetative state 1. 8% andthe dead 31. 5%. Conclusion Results showed acute posttraumatic cerebral hemisperic swelling is usually complicated by other kinds of brain injuries. In typical CT feather, the shife degree of the middlelines is not proportion to the thickness of intracranial hematoma. Decompressive operation with removing osteal pieces, high-dose glucocorticoid, combined with mannitol, and hyperventilation are effectivetherapy.