创伤后重型急性弥漫性脑肿胀临床治疗策略

Clinical treatment of severe post-traumatic acute diffuse brain swelling

摘要:

目的 探讨重型创伤后急性弥漫性脑肿胀（PADBS）患者保守治疗与手术治疗的疗效。方法 分析 2016年1月—2019年12月该院神经外科收治的44例重型PADBS患者，根据治疗方式分为手术组和保守治疗组，统计入院时格拉斯哥昏迷量表（GCS）评分、头颅CT检查情况、伤后6个月格拉斯哥预后量表（GOS）评分等资料。结果 两组患者入院时年龄、性别及GCS评分比较，差异无统计学意义（P>0.05）。两组患者伤后6个月时GOS评分比较，差异无统计学意义（P>0.05），但两组住院时间比较，差异有统计学意义（P<0.05），手术组长于保守治疗组。结论 重型PADBS在无瞳孔变化及GCS评分下降的情况下，可密切观察病情下选择保守治疗。

Abstract:

Objective To explore the efficacy of conservative and surgical treatment for severe post-traumatic acute diffuse brain swelling (PADBS).Methods Forty-four patients, who were admitted to the Department of Neurosurgery in our hospital for severe PADBS from January 2016 to December 2019, were divided into surgery group and conservative treatment group. The Glasgow Coma Scale (GCS) score on admission, head CT examination results, Glasgow Outcome Scale (GOS) score at six months after injury, and length of hospital stay were statistically analyzed.Results There were no significant differences in age, sex, GCS score on admission, and GOS score at six months after injury between the two groups (P>0.05). However, the surgery group had a significantly longer length of hospital stay than the conservative treatment group (P<0.05).Conclusions Patients with severe PADBS can choose conservative treatment under close clinical observation if they do not have pupil changes or reduction in the GCS score.