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为探讨脑震荡后遗症形成的相关因素,对86例脑震荡后遗症临床资料进行回顾性分析。结果表明,脑震荡后遗症分为5型,其中Ⅰ型(头晕型)占44.1%,Ⅱ型(耳鸣、耳聋型)占23.2%,Ⅲ型(失眠多梦型)占16.2%),Ⅳ型(记忆力减退型)占12.7%,Ⅴ型(精神症状型)占3.4%。相关因素与分析表明:①伤因中击打伤和重物砸伤所致脑震荡的后遗症发生率较高;②后遗症发生率随着伤后意识障碍时间延长而增多;③以3D-TCD检测结果为指标,脑血管痉挛时间与后遗症发生率显著相关;④尼莫地平治疗组的发生率显著低于其他两组。结论:脑震荡伤后引起脑血管痉挛,造成脑缺血、缺氧时间过长,是形成脑震荡后遗症主要原因,伤后是否残留后遗症,主要取决于意识障碍时间和脑血管痉挛持续时间。及早解除脑血管痉挛有助于降低其发生率。
To explore the related factors of concussion sequelae, clinical data of 86 cases of concussion sequelae were retrospectively analyzed. The results showed that sequelae of concussion were divided into 5 types, of which type Ⅰ (dizziness) accounted for 44.1%, type Ⅱ (tinnitus and deafness) accounted for 23.2%, type Ⅲ (insomnia and dream type) accounted for 16.2%), type Ⅳ Memory loss type) accounted for 12.7%, Ⅴ type (mental symptoms) accounted for 3.4%. The related factors and analysis showed that: ① the incidence of concussion due to hit hit and hit heavy injuries; ② the incidence of sequelae increases with the extension of time after injury; ③ detected by 3D-TCD The results as an indicator of cerebral vasospasm time and the incidence of sequelae was significantly related; ④ nimodipine treatment group was significantly lower incidence of the other two groups. CONCLUSION: Cerebral vasospasm is induced after concussion injury, resulting in cerebral ischemia and hypoxia for too long. It is the main reason for the concussion of concussion. Whether the residual sequelae remains depends on the time of disturbance of consciousness and the duration of cerebral vasospasm. Early release of cerebral vasospasm helps to reduce its incidence.