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目的探讨对冲性双额叶脑挫裂伤临床特点及诊治。方法回顾分析120例患者的临床资料。结果本组植物生存2例,死亡5例,其中2例死于多脏器功能衰竭,3例死于脑疝中枢性脑干功能衰竭。根据格拉斯哥预后评分(GOS)结果:恢复良好94例,中残18例,重残8例。结论对双额叶脑挫裂伤患者的手术指征应适当放宽,有弥漫性脑肿胀者即便神志清醒也应及早行减压手术。清除血肿及碎裂无生机的脑组织后,一般即可减轻脑水肿、脑肿胀,消除或减轻血肿本身及脑水肿、脑肿胀产生的占位效应,达到满意的内减压效果。
Objective To investigate the clinical characteristics and diagnosis and treatment of hemorrhagic double frontal lobe contusion. Methods The clinical data of 120 patients were retrospectively analyzed. Results In this group, there were 2 cases of plant survival and 5 cases of death, of which 2 cases died of multiple organ failure and 3 died of central brain stem failure of hernia. According to Glasgow Outcome Score (GOS) results: 94 cases were recovered well, 18 cases were moderate disability and 8 cases were severely disabled. Conclusions The surgical indications for patients with bilateral frontal lobe contusion should be appropriately relaxed. Those with diffuse brain swelling should undergo decompression surgery as soon as possible even if they are conscious. Removal of hematoma and fragmentation of the brain after the brainless, generally can reduce cerebral edema, brain swelling, eliminate or reduce the hematoma itself and brain edema, brain swelling placeholder effect to achieve satisfactory decompression effect.