摘要
目的 分析脑弥漫性轴索损伤 (diffuseaxonalinjury,DAI)的临床特点及其与预后的关系。 方法 依据伤后昏迷的时间 ,将我科 1997年 8月～ 1999年月 12月收治的 34例DAI病人分为轻、中、重 3组 ,分析 3组病人的临床特点、CT资料及治疗后的结果 ;分析原发昏迷和入院时GCS与预后的关系。 结果 重度组 2 6例 (76 % ) ,伤后 2 4h内CT扫描 12例 (4 6 % )发现脑不同部位有点状高密度影 ,2 6例中死亡 8例 ,预后良好者 7例 ;中度组 5例 (15 % ) ,CT扫描仅 1例发现脑内点状高密度影 ,除中残 1例外其余恢复良好 ;轻度组 3例 (9% ) ,CT扫描无异常发现 ,全部恢复良好。中 -重度组入院时GCS明显低于轻度组 (P <0 .0 5 ,P <0 .0 1) ,原发性昏迷持续时间亦显著长于轻度组。 结论 脑外伤后持续昏迷超过 6h而CT扫描无明显占位病灶者 ,即可诊断DAI;临床分度。
Objective To analyze the clinical characteristics and prognosis of the patients with cerebral diffuse axonal injury (DAI). Methods A total of 34 patients with DAI hospitalized in the department from the year of 1997 to 1999 were divided into three groups, that is, the mild group (n=3, 9%), the moderate group (n= 5, 15%) and the severe group (n=26, 76%) according to the persistent time of coma after injury. The clinical characteristics, the materials of CT scanning and the results of the treatment were analyzed. Furthermore, the relationships between the time of primary coma, Glasgow Coma Scale (GCS) and the prognosis were also analyzed. Results In the severe group, dot high density shadows were found in different sites of the brain of 12 patients (46%) by CT scanning within 24 hours after head injury, in the end, 8 patients died and 7 had good results. In the moderate group, dot high density shadow was found in only one case and one was moderately disabled. In the mild group, no abnormality in CT scanning was found and all of the patients were found good prognosis. Conclusions It can be diagnosed as DAI if the primary coma is longer than 6 hours after head injury and no obvious occupied damage was found in the brain by CT scanning. The clinical division, GCS and the persistent time of primary coma are useful for the determination of the prognosis of DAI.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2001年第1期26-28,共3页
Chinese Journal of Trauma
关键词
脑损伤
弥漫性轴索损伤
临床特点
预后
Brain injuries
Tomography, x ray computed
Prognosis
Diffuse axonal injur
