颅脑损伤伴迟发性脑干梗死的相关临床因素分析

摘要

Objective To explore the mechanism,clinical features,diagnosis,treatment methods and prognosis of the traumatic brain injury with delayed brainstem infarction and to further enhance the understanding of this disease.Methods A retrospective analysis was made on the clinical data of 21 traumatic brain injured patients (15 males and 6 females) with delayed brainstem infarction confirmed by medical imaging,treated in our hospital between January 2009 and December 2012.Results The 21 patients had varying degrees of clinical brainstem injury symptoms.After three months,the outcomes scaled by Glasgow Outcome Scale (GOS)standard were as follows:3 with good recovery,7 moderate disability,3 serious disability,3 vegetable and 5 death,the mortality being 23.81％.Conclusion Despite a low occurrence rate,the traumatic brain injury with delayed brainstem infarction has a high rate of mortality and disability.Once the brainstem lesion is suspected and conditions permit,the brain MRI should be done in time,so that a confirmed diagnosis,a timely treatment and a favorable therapy effect can be given to better patents' life quality.%目的 探讨颅脑损伤后伴迟发性脑干梗死的发生机制、临床特点、诊疗方法及预后.方法 回顾性分析2009年1月-2012年12月在本院经影像学证实为颅脑损伤后迟发性脑干梗死的21例患者的临床资料.结果 本研究中21例患者临床均表现为不同程度的脑干受损症状.伤后3个月格拉斯哥(GOS)评估结果为恢复良好3例,中残7例,重残3例,植物生存3例,死亡5例,死亡率23.81％.结论 颅脑损伤伴迟发性脑干梗死的发生率虽不高,但病死率和致残率却较高.一旦怀疑脑干病变,条件允许时应及时行头颅MRI检查,以便明确诊断并及早治疗,提高患者的生存质量.