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目的:探讨弥漫性轴索损伤(diffuse axonal injury,DAI)的发病机制、临床特点、诊断及治疗方法,以提高治愈率,降低致残、致死率。方法:回顾性分析2000～2008年间一共92例临床诊断为弥散性轴索损伤患者的受伤机制、临床特征、影像学表现、治疗及预后。结果:DAI最常见原因为车祸伤(81.5%),其次为坠落伤(13%),其它(5.5%)。按GOS评分结果,治愈43例,中残10例,重残或植物生存22例,死亡17例。结论:DAI具有诊断、治疗困难,预后差等特点,GCS评分、昏迷时间和瞳孔变化是判定预后的重要指标。目前尚无特效治疗方法,应结合病人情况采用综合治疗。
Objective: To investigate the pathogenesis, clinical features, diagnosis and treatment of diffuse axonal injury (DAI) in order to improve the cure rate and reduce the disability and fatality rate. Methods: A total of 92 wounds, clinical features, imaging findings, treatment and prognosis were analyzed retrospectively in 92 patients diagnosed as diffuse axonal injury from 2000 to 2008. Results: The most common causes of DAI were traffic accident injuries (81.5%), followed by fall injuries (13%) and others (5.5%). According to GOS score, 43 cases were cured, 10 cases were disabled, 22 cases were severely disabled or had plant diseases, and 17 cases died. Conclusion: DAI has the characteristics of diagnosis, difficult treatment and poor prognosis. GCS score, coma time and pupil change are the important indexes to judge the prognosis. There is no effective treatment, the patient should be combined with comprehensive treatment.