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目的探讨重型颅脑损伤患者术后继发创伤性脑梗死的危险因素及防治措施。方法回顾性分析经开颅手术治疗的187例重型颅脑损伤患者的临床资料,根据术后半月内是否出现创伤性脑梗死分为创伤性脑梗死组与无创伤性脑梗死组,对可能造成创伤性脑梗死的因素,如性别、年龄、是否为多发伤、是否出现脑疝、是否合并有创伤性蛛网膜下腔出血等方面,进行统计学分析。结果本组187例重型颅脑损伤患者术后继发创伤性脑梗死21例,其中大面积脑梗死8例,非大面积脑梗死13例,创伤性脑梗死发病率11.23%,5例大面积脑梗死颅内压持续增高并形成脑疝再次手术扩大颅骨窗减压术;重型颅脑损伤术后是否出现创伤性脑梗死与性别无关(P>0.05),与年龄、伤情、多发伤、创伤性蛛网膜下腔出血有关(P<0.05)。结论重型颅脑损伤继发创伤性脑梗死与性别无关,与年龄、是否出现脑疝、是否为多发伤、是否合并有创伤性蛛网膜下腔出血有显著相关性;早期诊断和早期综合治疗才能改善患者预后,提高疗效。
Objective To investigate the risk factors and prevention and treatment of secondary traumatic cerebral infarction in patients with severe craniocerebral injury. Methods The clinical data of 187 patients with severe craniocerebral injury who underwent craniotomy were retrospectively analyzed. According to whether there was traumatic cerebral infarction within half a month after operation, they were divided into traumatic cerebral infarction group and non-invasive cerebral infarction group. Traumatic cerebral infarction factors, such as gender, age, whether multiple injuries, whether there is herniation, whether combined with traumatic subarachnoid hemorrhage and other aspects of statistical analysis. Results In this group of 187 patients with severe craniocerebral injury, 21 cases were followed up with traumatic cerebral infarction, including 8 cases of large-area cerebral infarction, 13 cases of non-large-area cerebral infarction, 11.23% of traumatic cerebral infarction, 5 cases of large area Cerebral infarction continued to increase intracranial pressure and the formation of hernia reoperation to expand the skull window decompression; whether severe traumatic brain injury after traumatic cerebral infarction has nothing to do with gender (P> 0.05), and age, injury, multiple trauma, Traumatic subarachnoid hemorrhage (P <0.05). Conclusions Severe traumatic brain injury secondary traumatic cerebral infarction has nothing to do with gender, age, brain herniation, whether multiple trauma, whether there is traumatic subarachnoid hemorrhage or not; early diagnosis and early comprehensive treatment ability Improve patient’s prognosis, improve curative effect.