颅脑损伤亚急性期病情恶化临床分析(附16例报告)

Subacute deterioration of head-injured patients:a clinical study of 16 cases.

目的 总结“轻、中”型颅脑损伤患者亚急性期病情恶化的临床特点。方法 回顾性分析我科1999年 3月～ 2 0 0 1年 1月间收治的在创伤亚急性期出现病情恶化的 16例“轻、中”型颅脑损伤病例的病历资料。结果 (1)亚急性硬膜下血肿形成、脑挫裂伤继发脑水肿和脑梗塞是颅脑损伤患者亚急性期病情恶化的常见原因 ,本组占 13例 (81.2 5 % ) ;(2 )本组有 12例 (75 % )在病情恶化后接受手术治疗。 12例 (75 % )预后良好 ,2例分别因继发脑室内出血或枕骨大孔疝而死亡。结论 尽管“轻、中”型颅脑损伤亚急性期病情恶化在临床上相对少见且多数患者预后良好 ,但仍有部分病例因此而致残或死亡 ,积极处理并尽可能避免类似情况的发生仍是颅脑损伤临床治疗的重点之一。

Objective To study the clinical features of 'mild'and'moderate'head injured patients worsening clinically during the subacute phase after trauma.?Methods The data of 16 cases of subacute deteriorated head injured hospitalized in our department from March 1999 to January 2001 were studied retrospectively.?Results (1)?Symptomatic subacute subdural hematoma, cerebral edema after brain contusion and cerebral infarction were the main causes of exacerbation during the subacute phase after trauma. (2)?There were 12 patients had been treated surgically after exacerbation.Among 16 cases,12 cases had a good prognosis with 2 cases died of intraventricular hemorrhage or cerebellar tonsillar hernia.?Conclusions Though head injured patients worsening clinically during the subacute phase after trauma are relatively rare,we should do our best in the treatment to avoid such worse results.