目的探讨颅脑外伤后多发性颅内血肿的临床特点、早期诊断及防治措施。方法回顾性分析152例外伤性多发性颅内血肿的病例资料。GCS 13-15分25例,9-12分46例,6-8分39例,3-5分42例。结果手术123例,非手术29例。随访12周,GOS5分(恢复良好)93例(61.2%),4分(轻残)18例(11.8%),3分(重残)22例(14.5%),2分(植物状态)7例(4.6%),1分(死亡)12例(7.9%)。死亡原因为多器官功能衰竭、脑干功能衰竭、颅内感染和肺部感染等。结论提高诊断意识、加强临床监测和动态CT扫描有助于多发性颅内血肿的早期诊断和治疗,并改善预后。
Objective To explore the clinical characteristics, early diagnosis, prevention and treatment of traumatic multiple intracranial hematomas. Methods The clinical data of 152 patients with traumatic multiple intracranial hematomas were analyzed retrospectively. The Glasgow Coma Scale(GCS) score was 13-15 in 25 patients, 9-12 in 46, 6-8 in 39 and 3-5 in 42. Results There were 123 patients receiving surgery and 29 with conservative treatment. The follow-up lasted for 12 weeks, the GOS was 5(good recovery) in 93 patients(61.2%), 4(moderate disability) in 18(11.8%), 3(severe disability) in 22(14.5%), 2(vegetative state) in 7(4.6%) and 1(death) in 12(7.9%). The main causes of death were multiple organ function failure, brainstem function failure,intracranial infection and pulmonary infection. Conclusion Improved diagnosis consciousness, enhanced clinical monitoring and dynamic CT scan would be helpful for the early diagnosis, early treatment and prognosis improvement of traumatic multiple intracranial hematomas.