额颞部对冲性脑损伤的救治分析

目的:探讨额颞部对冲性脑损伤的手术治疗策略,进一步提高额颞部对冲性脑损伤患者的治愈率。方法:对我科2003年6月～2008年6月手术的58例额颞部对冲性脑损伤患者的临床资料进行回顾性分析。结果:58例手术治疗的患者中,采用格拉斯哥治疗结果分级(GOS)标准对预后进行评估,良好33例,中残8例,重残9例,死亡8例;术前GCS>8分的19例中良好17例,中残2例,无重残及死亡。结论:对于额颞部对冲性脑损伤患者,临床上要密切观察病情变化,动态复查头颅CT,早期及时采用标准外伤大骨瓣开颅手术治疗,充分减压,有利于提高患者生存率与生存质量。

Treatment of contrecoup cerebral injury in forehead and temple region

Objective： To probe effective surgical procedures for contrecoup cerebral injury in forehead and temple region and to increase its cure rate. Methods： Clinical data of 58 patients with contrecoup cerebral injury in forehead and temple region who were admitted from June, 2003 to June, 2008 were retrospectively analyzed. Results： According to the Glasgow Outcome Scores （GOS）, 33 out of the 58 patients who underwent operation were classified as good recovery, 8 as moderate disability, 9 as severe disability, and 8 died; among 19 patients who were classified as Glasgow Coma Scale （GCS）〉8 before the operation, 17 cases were classified as good recovery after the operation and 2 as moderate disability with no disability or died case being presented. Conclusion. For patients with contrecoup cerebral injury in forehead and temple region, comprehensive measures including close monitor, repeated cerebral CT scan, craniotomy to reduce compression could raise the survival rate and life quality for the patients.