小儿中、重型颅脑损伤的救治

Diagnosis and treatment of the severe and medium craniocerebral injury in children.

目的 探讨小儿中、重型颅脑损伤的诊断和治疗。方法 回顾我院 1995年 1月至 1999年 12月收治的小儿中、重型颅脑损伤 15 2例。结果 重型颅脑损伤 10 3例 (极重型 39例 ) ,其中颅内血肿 4 5例 ,占 4 3.6 9%。中型颅脑损伤 4 9例。手术治疗 95例 ,非手术治疗 5 7例。 14 2例存活 ,其中 12 5例随访 6月至 3年 ,4 8例有脑软化灶 ,其中 10例与同侧脑室相通 ,5例确诊为外伤性癫痫。 10例死亡 ,病死率 6 .5 8%。结论 小儿中、重型颅脑损伤的伤情严重、变化快、及早确立诊断。

Objective To explore diagnosis and management of severe and medium craniocerebral injury in children.Methods From Jan.1995 to Dec.1999,one hundred fifty two cases with severe and medium craniocerebral injury were analysed retrospectively.Results Of 152 cases (98 male and 54 female),49 were with medium injury and 103 with severe injury,45 of whom were with tramatic intracranial hematomas(43.69%).Ninety five cases underwent surgical treatment,57 cases recieved no operation.Ten of them were dead and the mortality rate was 6.58%.Follow up of 125 cases ranged 6 months to 3 years,and it was found 48 cases were with cerebral softening,10 of whom had communicated ventricles of brain and 5 had tramatic epilepsy.Conclusion The severe and medium craniocerebral injury in children are critical and changeable,early diagnosis and rescue are very important.Appropriate and prompt treatment is crucial for achieving good results.