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目的探讨外伤后急性弥漫性脑肿胀治疗效果及影响疗效的主要因素。方法对31例外伤后急性脑肿胀患者的治疗资料进行回顾性分析。所有患者均接受去骨瓣减压手术和术后亚低温治疗。结果术后6个月按GOS评分标准评估:良好9例(占29.0%)、中残6例(占19.4%)、重残6例(占19.4%)、植物生存4例(占12.9%)、死亡6例(占19.4%)。结论早期去骨瓣减压和术后立即亚低温联合治疗,可以改善患者预后,而术前急性全脑肿胀和术中出现急性脑膨出,患者预后较差。
Objective To investigate the therapeutic effect of acute diffuse brain swelling after trauma and the main factors affecting the curative effect. Methods The data of 31 patients with acute brain swelling after trauma were retrospectively analyzed. All patients underwent craniofacial decompression and postoperative hypothermia. Results Six months after operation, the GOS score was evaluated in 9 cases (29.0%), 6 cases (19.4%), 6 cases (19.4%) and 4 cases (12.9% , 6 died (19.4%). Conclusions Early decompressive craniectomy combined with immediate postoperative mild hypothermia can improve the prognosis of patients. However, the preoperative acute whole brain swelling and intraoperative acute encephalocele have a poor prognosis.