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目的:探讨重型颅脑外伤患者早期术后治疗对脑梗死发生的影响。方法:重型颅脑外伤共133例,均采用常规去骨瓣开颅术清除血肿减压,根据术后急性期(3d)内收缩压状况分为A、B、C3组(<150mmHg,151～180mmHg,>180mmHg),术后行脱水及扩血管治疗。术后1、3、7d复查CT。结果:本研究病例共出现49例脑梗死,A、B、C3组分别为20、17、12例,其中死亡9例,A、C组分别为7例、2例。结论:收缩压过高或过低是重型路脑外伤患者术后脑梗塞发生及其预后的重要因素,术后急性期内维持收缩压于稍高状态(151～180mm-Hg)可有效减少患者脑梗死发生率,降低病死率。
Objective: To investigate the effect of early postoperative treatment on the incidence of cerebral infarction in patients with severe traumatic brain injury. Methods: A total of 133 cases of severe craniocerebral trauma were treated by conventional craniotomy to remove the hematoma decompression. According to the systolic pressure in the acute phase (3d), the patients were divided into three groups: A, B and C3 (<150mmHg, 180mmHg,> 180mmHg), postoperative dehydration and vasodilation. Postoperative 1,3,7 d review CT. Results: A total of 49 cases of cerebral infarction were found in this study. There were 20, 17 and 12 cases in group A, B and C3 respectively, of which 9 died and 7 cases in group A and 2 cases in group C, respectively. CONCLUSIONS: Systolic blood pressure is too high or too low is an important factor in the occurrence and prognosis of postoperative cerebral infarction in patients with severe traumatic brain injury. It is effective to maintain systolic blood pressure (151-180mm-Hg) during the acute phase of severe traumatic brain injury The incidence of cerebral infarction, reduce mortality.