【摘要】：目的回顧性分析研究大腦實(shí)質(zhì)多處挫裂傷患者的臨床表現(xiàn)、影像學(xué)檢查以及預(yù)后恢復(fù)情況,探討多處腦挫裂傷患者的臨床救治的量化指標(biāo),從而為臨床醫(yī)生的工作提供參考。方法對150例大腦挫裂傷總體積在30ml以上的多處腦挫裂傷患者的臨床救治及預(yù)后進(jìn)行回顧性分析,根據(jù)多處腦挫裂傷總體積50ml和≥50ml以及GCS評分≤8分和8分進(jìn)行分組研究,通過分析患者GOS預(yù)后評分,比較各組患者的預(yù)后情況。結(jié)果(1)對于多處腦挫裂傷總體積在30ml-50ml的A組病人,手術(shù)或非手術(shù)處理后患者的殘、死率無統(tǒng)計學(xué)差異(P0.05);對于腦挫裂傷總體積≥50ml的B組患者,手術(shù)與非手術(shù)治療的殘、死率有顯著統(tǒng)計學(xué)差異(P0.05),與非手術(shù)者比較,B組的手術(shù)者GOS 4-5分百分率較A組升高了31.9%,GOS 1-3分百分率較A組下降了31.9%。(2)對于多處腦挫裂傷GCS8分的C組病人,手術(shù)或是非手術(shù)處理后患者的殘、死率無統(tǒng)計學(xué)差異(P0.05);但對于GCS≤8分的D組病人,手術(shù)組和非手術(shù)組預(yù)后比較,結(jié)果顯示致殘、致死率具有顯著性差異(P0.05)。D組的手術(shù)者GOS4-5分百分率較C組升高24.7%,GOS 1-3分百分率較C組降低了下降了24.7%。結(jié)論對于多處腦挫裂傷的患者,若大腦部位多處挫裂傷總體積之和50ml以及GCS8分則多考慮非手術(shù)治療;若大腦部位多處挫裂傷總體積之和≥50ml以及GCS評分≤8分時應(yīng)考慮積極手術(shù)治療;若以腦挫裂傷總體積和GCS評分判斷的患者均指向手術(shù)治療,則盡可能行開顱去骨瓣手術(shù)治療,若一項(xiàng)指標(biāo)指向手術(shù)治療,則可根據(jù)患者的病情變化、年齡、體質(zhì)情況等多種因素綜合考慮是否行手術(shù)治療。這樣能夠盡早的決策手術(shù)與否,從而為手術(shù)患者節(jié)約觀察時間,最大程度的減輕腦挫裂傷患者的后遺癥,減輕患者的住院時間和經(jīng)濟(jì)負(fù)擔(dān)。
[Abstract]:Aim to analyze retrospectively the clinical manifestation, imaging examination and prognosis recovery of patients with multiple contusion and laceration of cerebral parenchyma, and to discuss the quantitative indexes of clinical treatment for patients with multiple cerebral contusion and laceration, so as to provide reference for clinicians' work. Methods the clinical treatment and prognosis of multiple cerebral contusion and laceration patients whose total volume of brain contusion and laceration were more than 30ml were retrospectively analyzed. According to the total volume of multiple brain contusion and laceration, 50ml and 鈮，

本文編號：2453411