额叶脑挫裂伤的临床表现与预后分析

The clinical manifestations and prognostic analysis of frontal lobe contusion and laceration of the brain

目的探讨额叶脑挫裂伤的临床表现与预后情况。方法根据患者入院时意识状况及头颅CT或MRI检查结果,并进行动态头颅CT和MRI追踪,选择保守或手术治疗。结果行保守或手术治疗后随访1年,GOS预后评分为恢复良好53例,较差26例,差10例。入院时神志清楚,动态追踪头颅CT和MRI结果仅表现为单纯脑挫裂伤或迟发脑内血肿<30 mL患者大多预后良好;入院时即表现昏迷,动态追踪头颅CT或MRI结果表现为迟发脑内血肿>30 mL伴环池显示不清或闭塞、合并脑干损伤的患者大多预后较差。结论对于入院时表现为嗜睡、昏睡或伴有躁动的患者,应密切监测其生命体征,并动态追踪头颅CT或MRI,对预后做出初步判断,选择合适的治疗方案。

Objective To investigate the clinical manifestations and prognosis of frontal brain contusion and laceration.Methods The choice of conservative treatment or surgery was made according to patients＇ consciousness,results of brain CT or MRI examination and a dynamic brain CT and MRI tracing,Results A one-year follow-up was conducted after the conservative treatment or surgery.According to GOS prognostic scores,good recovery was found in 53 cases,rather poor in 26 cases,and poor in 10 cases.The patients who was conscious on admission,in whom brain CT and MRI showed simple brain contusion and laceration or a delayed intracerebral hematoma less than 30 ml,had a favorable prognosis.Most patients who had a coma,delayed intracerebral hematoma traced by brain CT or MRT more than 30ml,unclear ring pool display or occlusion,and merged brain injury,normally had a poor prognosis.Conclusion For the drowsy,lethargy or dysohoria patients,we should closely monitor their life signs,make preliminary judgment of prognosis by dynamical brain CT or MRI,and choose appropriate regimens.