[1]于 烽,韩瑞璋,赵 保,等.外伤性脑梗死64例临床诊治[J].医学研究与战创伤救治(原医学研究生学报),2011,13(03):231-233.
YU Feng,HAN Rui-zhang,ZHAO Bao,et al.Diagnosis and treatment for posttraumatic cerebral infarction[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(03):231-233.
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外伤性脑梗死64例临床诊治(
)
YU Feng,HAN Rui-zhang,ZHAO Bao,et al.Diagnosis and treatment for posttraumatic cerebral infarction[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(03):231-233.
)《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]
- 卷:
- 第13卷
- 期数:
- 2011年03期
- 页码:
- 231-233
- 栏目:
- 出版日期:
- 2011-05-20
文章信息/Info
- Title:
- Diagnosis and treatment for posttraumatic cerebral infarction
- 文章编号:
- 1672-271X(2011)03-0231-03
- 分类号:
- R651.1+5
- DOI:
- -
- 文献标志码:
- A
- 摘要:
- 目的 探讨外伤性脑梗死的发病机制和治疗效果。方法 回顾性分析中重度脑外伤患者经CT、MRI证实的外伤性脑梗死患者的临床、影像学表现及治疗结果。结果 709例中重度脑外伤中64例出现脑梗死，发病率为9.0%。脑梗死发生时间为外伤后48 h~2周，38例发生于去骨瓣减压术后，35例发生在基底核区。随访6个月:恢复良好31例，中度残废18例，重度残废5例，植物状态6例，死亡4例。结论 外伤性脑梗死的发生与脑血管钝性损伤、低灌注压、颅内压增高及去骨瓣减压术密切相关。治疗上强调早期积极处理预防脑梗死的发生。
- Abstract:
- Objective To investigate the pathogenesis and treatment effects of posttraumatic cerebral infarction (PTCI). Methods The clinical manifestations, CT and MR imaging and treatment effects of patients with PTCI were retrospectively analyzed. Results Of the 709 consecutive patients with moderate or severe traumatic brain injury (TBI), 64 (9%) had a confirmed PTCI. The cerebral infarction developed between 48 hours and 2 weeks after injury. In 38 cases, the PTCI occurred after decompression craniotomy. In 35 cases, the PTCI appeared at the area of basal ganglia. The follow-up was carried out from 6 months after injury. 4 patients died,6 were in a vegetative state,5 had severe disability,18 had middle disability and 31 showed favorable outcome. Conclusion The blunt cerebral vascular injury,low systolic BP,intracranial hypertension,and decompression craniotomy may be risk factors for PTCI in patients with moderate or severe traumatic brain injury. The early positive clinical management reduces the risk of infarction.
参考文献/References:
[1]Tawil I, Stein DM, Mirvis SE, et al.Posttraumatic cerebral infarction: incidence, outcome, and risk factors[J].J Trauma,2008,64(4):849-853.
[2]Tian HL, Geng Z, Cui YH, et al.Risk factors for posttraumatic cerebral infarction in patients with moderate or severe head trauma[J].Neurosurg Rev, 2008, 31(4):431-436.
[3]Steinborn M, Schaffeler C, Kabs C, et al.CT and MR imaging of primary cerebrovascular complications in pediatric head trauma[J].Emerg Radiol, 2010, 2(1):95-99.
[4]张益群,殷孝刚,王佩莉,等.川穹嗪、胞二磷胆碱保健治疗脑梗死30例疗效观察[J].东南国防医药，2005,7(1):49.
[5]朱 敏,何晓军,王 蔚,等.阿拓莫兰治疗急性脑梗死的疗效观察[J].东南国防医药，2005,7(1):34-35.
[6]史 跃,孟宪俊,王忠勤,等.机械碎栓联合液体冲击法介入治疗急性脑梗死[J].东南国防医药，2008,10(6):442-443.
[7]Stein DM, Boswell S, Sliker CW, et al.Blunt cerebrovascular injuries: does treatment always matter[J].J Trauma, 2009,66(1):132-143.
[8]Kim KT, Park JK, Kang SG, et al.Comparison of the effect of decompressive craniectomy on different neurosurgical diseases[J].Acta Neurochir (Wien), 2009,151(1):21-30.
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