【摘要】 目的探讨颞额叶脑挫裂伤伴小血肿及基底池变化患者的治疗决策。方法按意识、脑挫裂伤面积或血肿量、基底池变化三项评分,对274例患者分型、治疗方案与预后进行回顾分析。结果Ⅰ型88例:立即手术56例,死亡8例;延迟手术24例,死亡9例;非手术治疗8例全部死亡。Ⅱ型139例:立即手术11例;延迟手术72例,死亡11例;非手术治疗56例。Ⅲ型47例非手术治愈。结论Ⅰ型应立即手术;Ⅱ型59·7%需要手术,应动态CT复查再评分决定,前48h内应每4~8小时复查CT一次;Ⅲ型应非手术治疗。该“三3”评分法可在临床症状恶化之前作为治疗决策的量化指标。更多还原

【Abstract】 ObjectiveTo explore the the treatment decision of contusion and laceration of the brain at temporal lobe and frontal lobe with small hematoma and base pond changes.MethodsAccording to three grades of consciousnees,areas of brain contusion or quantity of hematoma,and changes of base pond,274 patients were divided into different types,then the types,the treatment regime and the prognosis of them were analyzed retrospectively.Results88 of type Ⅰ:56 was operated immediatelly in which 8 died;24 had delayed operations in which 9 died;8 without operations died all.139 of type Ⅱ:11 was operated immediatelly;72 had delayed operations in which 11 had died;56 without operations.Type Ⅲ:47 without operations.ConclusionsType Ⅰ should operate immediatelly;59.7% of type Ⅱ needed operations,and should recheck dynamically by CT.Especially in the first 48 hours,patients should be rechecked by CT every 4～8 hours.Then make a desicion by the regrade.Type Ⅲ not need operation.These "three-3" methods of grade could be regarded as the quantification index of treatment decision before deterioration.更多还原