双侧额叶脑挫裂伤致脑中心疝的临床诊治分析

Clinical diagnosis and treatment of brain central hernia caused by bilateral frontal lobe contusion

目的 探究双侧额叶脑挫裂伤致脑中心疝的临床诊治方法及治疗效果。方法 106例双侧额叶脑挫裂伤致脑中心疝患者,根据Plum脑中心疝分期标准分为间脑期组(62例)与非间脑期组(44例)。给予两组患者手术治疗,对比两组预后效果。结果 间脑期组患者格拉斯哥预后量表(GOS)评分5分40例, 4分12例, 3分5例, 2分4例, 1分1例;非间脑期患者GOS评分5分0例, 4分9例,3分13例, 2分10例, 1分12例。间脑期组患者GOS评分明显高于非间脑期组,差异有统计学意义(Z=6.1717, P<0.05)。结论 对双侧额叶脑挫裂伤致脑中心疝间脑期进行早期识别,及时对患者展开开颅手术治疗,可有效提高抢救成功率,积极改善患者的预后。

Objective To investigate the clinical diagnosis and treatment of patients with brain central hernia caused by bilateral frontal lobe contusion.Methods A total of 106 patients with brain central herniation caused by bilateral frontal lobe contusion were divided into diencephalic phase group(62 cases)and nondiencephalic phase group(44 cases)according to the Plum staging standard of brain central hernia.All patients received surgical treatment,and the prognosis of the two groups was compared.Results Glasgow outcome scale(GOS)score in the diencephalic phase group was 5 points in 40 cases,4 points in 12 cases,3 points in 5 cases,2 points in 4 cases,and 1 point in 1 case;GOS score in non-diencephalic phase group was 5 points in 0 case,4 points in 9 cases,3 points in 13 cases,2 points in 10 cases,and 1 points in 12 cases.The GOS score in the diencephalic phase group was significantly higher than that in the non-diencephalic phase group,and the difference was statistically significant(Z=6.1717,P<0.05).Conclusion Early recognition of the diencephalic phase of brain central hernia caused by bilateral frontal lobe contusion and timely craniotomy can effectively improve the success rate of rescue and the prognosis of patients.