摘要
目的总结分析儿童脑外伤后大面积脑梗死的临床特点。方法回顾性研究33例儿童脑外伤后大面积脑梗死患儿的临床资料。结果致伤原因：坠落伤21例，交通车祸伤10例，打击伤1例，重物砸伤1例。大面积脑梗死在伤后ld内出现9例，伤后1-3d出现14例，伤后4～7d出现7例，伤后〉7d出现3例。手术治疗18例，主要行颅内血肿清除术、去骨瓣减压术等。患儿在无出血倾向后均接受抗血小板聚集、预防脑血管痉挛及扩容等对症支持治疗。随访6-24个月，根据格拉斯哥预后评分判定预后：恢复良好18例，轻度残疾6例，重残1例，植物生存1例，死亡7例。结论儿童脑外伤后大面积脑梗死患儿以坠落伤和交通车祸伤为主，经过积极治疗后，等病情稳定后再行积极的康复综合治疗，存活患儿仍可获得相对满意的预后。
Objective To analyze the infarction after traumatic brain injury. Methods clinical characteristics of children massive cerebral The clinical data of 33 children with massive cerebral infarction after traumatic brain injury were retrospectively analyzed. Results Among the 33 children, 24 cases suffered from falling, 10 cases were involved in traffic accidents, 1 case suffered from violence and 1 case was hit by falling object. The massive cerebral infarction occurred in all objects： 9 cases in 1 day after head trauma, 14 cases in 1 - 3 days, 7 cases in 4 - 7 days, and 3 cases after 7 days. Eighteen patients were performed operation to evacuate the intracranial hematoma and decompression. Antiplatelet agents, calcium antagonist and low molecular dextran were administered in all patients after exclusion of bleeding tendency. The follow-up period of all children ranged from 6 months to 24 months. According to Glasgow outcome score （GOS）： 18 cases showed a good outcome, 6 cases were moderately disabled, 1 case was severely disabled, 1 case survived in a permanent vegetative state and 7 cases died. Conclusions The main causes of children massive cerebral infarction with traumatic brain injury are falling and traffic accident. With proactive treatment, the prognosis of children survivors is acceptable.
出处
《中国医师进修杂志》
2016年第4期350-353,共4页
Chinese Journal of Postgraduates of Medicine
基金
浙江省科技厅基金资助项目（2015C33144）
关键词
儿童
脑损伤
脑梗塞
Child
Brain injuries
Brain infarction
