重型脑挫裂伤并发迟发性颅内血肿36例报告

Report of 36 cases on severe brain injury complicated delayed intracranial hematoma

目的 总结重型脑挫裂伤并发迟发性颅内血肿的诊治经验。方法 回顾性分析我院近年来收治的重型脑挫裂伤并发迟发性颅内血肿的患者36例。结果 经治疗1月后按GCS评定,保守治疗6例,恢复良好2例,中残2例,重残1例,死亡1例;手术治疗30例,恢复良好18例,中残6例,重残3例,植物状态1例,死亡2例。结论严密动态观察,尽早开颅手术清除血肿,解除颅高压,防治术后并发症是救治的关键;对单纯局灶性脑挫裂伤并发迟发颅内血肿者术后效果良好,对广泛性脑挫裂伤、脑肿胀或脑干伤并发迟发性颅内血肿者预后不良。

Objective To summarize diagnosis and therapeutic experience of severe brain injury complicated delayed intracranial hematome. Methods 36 cases of severe brain injury complicated late intracranial hematoma were reviewed retrospectively in our hospital of late years. Results Non-operative treatment 6 cases,2 cases survived well,2 cases suffered from moderate disability, 1 case severe deficit, 1 case death; Operative treatment 30 cases, 18 cases survived well,6 cases suffered from moderate disabolity,3 cases severe deficit, 1 case vegetative and 2 cases death according to GOS after one months. Conclusion Shifting observation exactly, Intracranial hematoma evacution early, Relieved intracranial hypertension, Treated complication after operation were keys in severe brain injury complicated late intracranial hematoma.The features were well in simple localized brain injury complicated late intracranial hematoma after operation,The prognosis was poor in widely brain injury,brain swelling or brain stem injury complicated late intracranial hematomla.