双额叶脑挫裂伤的临床特点及诊治

Clinical characteristics and treatment of contusion and laceration of double frontal lobe

目的总结双额叶脑挫裂伤的临床、影像学特点以及手术时机、手术指征的把握和救治体会。方法回顾分析31例双额叶脑挫裂伤患者的临床、影像学资料,包括手术治疗20例(急诊手术12例,其中保守治疗过程中病情恶化后再行手术治疗8例),保守治疗11例。结果急诊手术12例恢复良好8例,中残2例,重残2例;保守治疗11例,均恢复良好;入院观察病情加重后手术治疗8例,恢复良好3例,中残1例,重残2例,死亡2例。结论双额叶脑挫裂伤入院时需严密观察,动态复查头颅CT,准确把握手术时机,适当放宽手术指征,尽早手术,可有效提高救治效果。

Objective To summarize the clinical experiences in treating contusion and laceration of double frontal lobe,including operation time and surgical indication.Methods The clinical data of 31 patients with contusion and laceration of double frontal lobe were analyzed retrospectively.20 were operated and 11 conservative treated.Results All patients were followed-up from 6 months to 3 years,showing that of 22 were recovered well,3 moderate disabled,4 severe disabled and 2 died,according to the Glasgow Outcome Scale（GOS）.Conclusion Most of the patients have mild disturbance of consciousness,but careful observation of consciousness and dynamic cerebral CT examination were very important for the patients.And the prognosis can be improved if the operation is timely.