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目的:探讨重型颅脑损伤后早期精神障碍临床特征及治疗方法,以提高患者的生活质量。方法:对我院48例重型颅脑损伤后早期精神障碍患者进行回顾性分析,观察精神障碍出现的时间、精神障碍的类型及预后及颅脑损伤的部位与精神障碍的关系。结果:重型颅脑损伤后精神障碍主要出现在伤后3周内,多继发于颞叶损伤,其次为额叶。临床上主要有躁狂型、抑郁型、痴呆型、精神分裂性等四型,其中以躁狂型为多见。通过治疗后,<1个月精神症状痊愈25例、<2个月痊愈13例、治疗>2个月仍有精神症状10例。结论:颅脑损伤后精神障碍在原发脑损伤的有效治疗前提下,辅以抗精神障碍药物治疗、心理治疗及高压氧治疗等可取得较好疗效。
Objective: To investigate the clinical features and treatment of early mental disorders after severe craniocerebral injury in order to improve the quality of life of patients. Methods: A retrospective analysis was performed on 48 patients with early-stage mental disorders after severe craniocerebral injury in our hospital. The duration of mental disorders, the type and prognosis of mental disorders and the relationship between the brain injury sites and mental disorders were observed. Results: After severe craniocerebral injury, mental disorders mainly occurred within 3 weeks after injury, mostly secondary to temporal lobe injury, followed by frontal lobe. Clinically there are manic, depression, dementia, schizophrenia and other four types, of which manic type is more common. After treatment, <1 month mental symptoms recovered in 25 cases, <2 months cured in 13 cases, treatment> 2 months there are still mental symptoms in 10 cases. Conclusion: The mental disorders after craniocerebral injury can achieve better curative effect in the treatment of primary brain injury, supplemented by antipsychotic drug therapy, psychotherapy and hyperbaric oxygen therapy.