创伤性胼胝体血肿13例临床分析

Clinical Analysis of Traumatic Lesions of Corpus Collosum in 13 Cases

目的探讨创伤性胼胝体血肿的损伤机制、病理机制,总结创伤性胼胝体血肿的临床表现特点、临床分型、治疗方案的选择及治疗方法,为今后的临床诊疗工作提供借鉴。方法对深圳市松岗人民医院2004年2月-2011年5月所收治的创伤性胼胝体血肿13例的临床资料进行回顾分析。结果 13创伤性胼胝体血肿患者采用保守治疗5例,手术治疗8例;按GOS结果分级标准对13创伤性胼胝体血肿患者的治疗结果进行评估:Ⅰ级(死亡)1例(7.69%),Ⅱ级(植物生存)1例(7.69%),Ⅲ级(重残)3例(23.07%),Ⅳ级(中残)3例(23.07%),Ⅴ级(良好)5级(38.46%)。结论胼胝体血肿合并有弥漫性轴索损伤存在,病情重,治疗任务繁重,患者预后差,动态症状及体征和头颅CT监测,规范化地治疗是提高患者生存率及生存质量的保证。

Objective To analyze the injury mechanism and pathology mechanism of the hemorrhage in the traumatic corpus callosum, summarize the clinical characteristic, types, the choice of the treatment schedule and treatment method, and provide ref- erence for the clinical management of this disease. Methods To analyze retrospectively the clinical data of 13 cases of hemor- rhage in the traumatic corpus collosum in our hospital from February 2004 to May 2011. Results In all 13 cases of hemorrhage in traumatic corpus eollosum,5 eases were treated with the conservative treatment,8 cases with operative treatment. According to GOS, the treatment effect of 13 patients were ： 1 eases （7.69%） were level I （dead）, 1 case （7.69%） level lI （ vegetative）, 3 cases （ 23.07 % ） level Ill （ severe disability）, 3 cases （ 23.07 % ） level IV （ residual ） and 5 cases （ 38.46% ） level V （ good ）. Conclusion Hemorrhage in the corpus callosum is often combined with the diffuse axonal injury （DAI）, the illness is serious and prognosis of patients are poor. By means of dynamic monitoring of symptoms, signs, brain CT and standardized treatment is the assurance of improving the survival rate and the quality of life of patients.