Labbe's静脉引流区脑挫裂伤的临床特点与手术治疗

The performance and treatment of contusion and laceration of brain in Labbe's venous drainage area

目的探讨Labbe's静脉区脑挫裂伤的临床特点,以及形成机制、挫裂伤灶发展特点、手术方法和降低其致死致残率的措施。方法回顾性分析近5年来收治的29例Labbe's引流区脑挫裂伤患者的临床资料。总结其临床表现、受伤机制﹑影像学﹑疾病发展特点﹑术中所见﹑后续并发症,以及处理措施和预后等。结果该区损伤自有特点,术中均证实存在静脉性损伤;迟发血肿发生率较高,挫裂伤灶水肿范围大,创面止血困难;后期病情变化大,是影响预后的重要因素。结论针对Labbe's静脉区脑挫裂伤损伤特点,及时进行影像学检查,及时手术,以及合适的手术方法;结合术后的病情监测与治疗,可以降低病死率和致残率。

Objective To explore the mechanism of injury of brain in Labbe＇s venous drainage area, the development of lesion and operative skill. Methods A total of 29 cases of patients with contusion and laceration of brain were analyzed in the past five years. We reviewed the data of imaging characteristics, disease development, what we could see during the operation, the subsequent development of complications and clinical prognosis and so on. Results The lesion of Labbe＇s venous drainage area has special features. It has been proved that veins were lesioned during intraopcrative , and the incidence rate of late-onset type cerebra] hemorrhage is high, and the range in the cerebral edema of contusion and laceration is large, and the hemorrhage is stopped difficultly, the pathogenctic condition get worse quickly at the later stage, which is the important factors affecting prognosis independently. Conclusion On the basis of the lesion features of Labbe＇s venous drainage area in contusion and laceration of brain, the mortality and morbidity can be reduced if the patients are examined by CT scan timely , are operated timely with appropriate skills, and are combined with postoperative standard treatment.