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目的探讨外伤性急性弥漫性脑肿胀的最佳诊治方法,进一步提高对患者的诊治水平。方法回顾性分析47例脑肿胀患者,依据脑肿胀类型及入院时临床状态分别给予开颅大骨瓣减压术及非手术综合治疗,对其预后进行评估。结果 26例患者接受一侧额颞顶或双侧额颞顶开颅大骨瓣减压术,结果死亡16例(61.6%),良好4例(15.4%),中残3例(11.5%),重残1例(3.8%),植物生存2例(7.7%);21例患者非手术治疗,结果死亡8例(38.1%),良好6例(28.6%),中残5例(23.8%),重残2例(9.5%)。两组比较,疗效差异明显(P<0.05)。结论外伤性急性弥漫性脑肿胀患者依据脑肿胀类型,尽早采用去骨瓣减压和综合治疗,可挽救相当一部分已发生脑疝患者的生命,不要轻易放弃救治。
Objective To explore the best method of diagnosis and treatment of traumatic acute diffuse brain swelling and further improve the diagnosis and treatment of patients. Methods A total of 47 patients with brain swelling were retrospectively analyzed. The prognosis was evaluated according to the types of cerebral edema and the clinical status at admission. The patients were given craniotomy decompression and non-surgical treatment respectively. Results Twenty-six patients underwent frontotemporal or bilateral frontotemporal craniotomy craniotomy decompression, resulting in 16 deaths (61.6%), 4 (15.4%) and 3 (11.5% , Severe disability (3.8%) and plant survival in 2 (7.7%). Twenty-one patients were non-surgical and the results were 8 deaths (38.1%), 6 (28.6% ), Severe disability in 2 cases (9.5%). The difference between the two groups was significant (P <0.05). Conclusion According to the type of brain swelling, traumatic acute diffuse brain swelling can be used as soon as possible to reduce the pressure and comprehensive treatment of cranial hernia, which can save a considerable part of the lives of patients with cerebral hernia. Do not give up treatment easily.