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目的探讨广泛脑挫裂伤导致脑中心疝的临床特征和诊治策略。方法对1999~2006年中35例广泛脑挫裂伤导致脑中心疝的临床资料进行回顾性分析。结果随访半年,根据GOS评价治疗效果:非手术组11例:好转1例,中残1例,植物状态3例,死亡6例。手术组24例:好转13例,中残3例,植物状态5例,死亡3例。结论对广泛脑挫裂伤容易导致脑中心疝要高度重视,做出早期预判、诊断以及尽早进行手术,使病人在中心疝间脑期得到及时有效的治疗,是降低致残率和死亡率的关键。
Objective To investigate the clinical features and diagnosis and treatment strategies of brain central hernia caused by extensive cerebral contusion and laceration. Methods A retrospective analysis was performed on the clinical data of 35 cases of extensive cerebral contusion and laceration leading to central brain hernia in 1999-2006. The results were followed up for six months, according to GOS evaluation of the treatment effect: non-surgical group of 11 patients: improved in 1 case, 1 case of disabled, plant status in 3 cases, 6 cases of death. The operation group of 24 patients: improved in 13 cases, 3 cases of disabled, plant status in 5 cases, 3 cases of death. Conclusions The extensive brain contusion and laceration can easily lead to the central herniation of the brain and attach great importance to early prognosis, diagnosis and early operation, so that the patient can receive timely and effective treatment in the central herniation period to reduce the morbidity and mortality key.