原发性脑干损伤的治疗(附126例报告)

Treatment of primary trauma in the brainstem: analysis of 126 cases

目的探讨原发性脑干损伤的治疗方法与效果。方法 总结分析126例原发性脑干损伤病例的治疗与效果,对其中的大部分病例采用早期控制性通气、亚低温、钙拮抗剂及神经节苷脂治疗。结果伤后2周,死亡35例（27.78％）,主要死因为中枢性呼吸功能衰竭;伤后半年,死亡50例（39.68％）,植物生存12例（9.52％）,重残11例（8.73％）,中残17例（1.40％）,恢复良好38例（30.16％）。结论早期控制性通气、亚低温、钙拮抗剂及神经节苷脂治疗可明显降低原发性脑干损伤的死残率。

Objective To explore the therapeutic approaches and observe their effects on primary traumatic injuries in the brainstem. Methods A summary analysis of the therapeutic effects was carried out in 126 cases of primary traumas in the brainstem, most of which were given controlled ventilation at early stages of the injury, mild hypothermia, Ca2+ antagonist and ganglioside GM1 therapy. Results Death occurred in 35 cases (27.78%) within 2 weeks following brain trauma, mainly due to central respiratory failure. Six months after brain trauma, totally 50 deaths (39.68%) occurred, with 12 cases (9.52%) lapsing into vegetative state, 11 cases (8.73%) severely disabled, 17 cases (13.40%) moderately disabled, and 38 cases (30.16%) enjoying favorable recovery. Conclusion Controlled ventilation at early stages of the injury, mild hypothermia, Ca2+ antagonist and GM1 therapy can immensely reduce the mortality and disability rate of patients with primary traumas in the brainstem.