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目的研究并探讨颅脑创伤后继发脑梗死的临床诊治要点,为临床诊治颅脑创伤后继发脑梗死提供借鉴和帮助。方法选取2013年3月~2017年8月期间我院收治的1056例颅脑创伤后继发脑梗死患者作为研究对象,对这1056例颅脑创伤后继发脑梗死患者的临床资料进行回顾性研究,归纳总结颅脑创伤后继发脑梗死的颅部CT检查结果、治疗方法及转归情况,并对颅脑创伤后继发脑梗死的原因进行因素分析。结果经颅脑CT检查,1056例颅脑创伤后继发脑梗死患者中,共有169例双侧多发梗死病灶、332例单侧基底节区梗死病灶、114例单侧顶叶梗死病灶、153例额叶梗死病灶、161例枕叶梗死病灶、127例颞叶梗死病灶,无1例漏诊或误诊。经保守治疗或手术治疗,随访1年发现,1056例患者的死亡率为9.85%,有104例死亡病例,存活病例多于死亡病例(P<0.05)。因素分析后发现,颅脑创伤后继发脑梗死的原因主要为创伤性休克、脑疝、蛛网膜下腔出血、低血压、高血糖、高龄、大量脱水。结论颅脑创伤后应对患者进行加强监护,针对引起继发性脑梗死的原因进行针对性干预,以减少继发性脑梗死的发生,同时,及时复查其颅脑CT,以便及时发现继发性脑梗死病灶,给予患者科学合理的治疗,以改善其预后。
Objective To study and discuss the clinical diagnosis and treatment of secondary cerebral infarction after traumatic brain injury and provide reference and help for the clinical diagnosis and treatment of secondary cerebral infarction after traumatic brain injury. Methods From March 2013 to August 2017, 1056 patients with secondary cerebral infarction after traumatic brain injury admitted to our hospital were selected as the research object. The clinical data of 1056 patients with secondary cerebral infarction after traumatic brain injury were retrospectively studied. Summarizes craniocerebral traumatic cerebral infarction after craniocerebral CT examination results, treatment and prognosis of cases, and the cause of cerebral infarction secondary to cerebral trauma factor analysis. Results After craniocerebral CT examination, there were 169 cases of bilateral multiple infarction, 332 cases of unilateral basal ganglia infarction, 114 cases of unilateral parietal infarction, 153 cases of cerebral infarction 161 cases of infarction of occipital lobe and 127 cases of temporal lobe infarction, none of them missed or misdiagnosed. After conservative treatment or surgical treatment, one year follow-up found that the mortality rate of 1056 patients was 9.85%, there were 104 deaths and more deaths than survivors (P <0.05). Factor analysis found that the main cause of secondary cerebral infarction after traumatic brain injury traumatic shock, hernia, subarachnoid hemorrhage, hypotension, high blood sugar, old age, a lot of dehydration. Conclusion Patients should be intensively monitored after craniocerebral trauma, and targeted intervention should be given to the causes of secondary cerebral infarction so as to reduce the occurrence of secondary cerebral infarction. At the same time, their brain CT should be promptly reviewed to find out the secondary Cerebral infarction lesions, given to patients with scientific and rational treatment to improve their prognosis.