中国现代手术学杂志2013，Vol.17Issue(1)：47-50,4.
儿童颅脑损伤的临床特点及手术策略(附257例分析)
Clinical Features and Surgical Strategies of Craniocerebral Trauma in Children: A Report of 257 Cases
陈静 1石磊 1刘宇 1张佳兴 1谷美玲1
作者信息
摘要
Abstract
Objective To analyze the clinical features and surgical treatment of traumatic brain injury in children. Methods The clinical data of 257 children with traumatic head injury admitted to our hospital from January 2003 to December 2010 were analyzed retrospectively. The patients aged from 1 to 14 years with an average of 6. 3 years, including 52 cases aged less than 3 years, 98 cases aged from 3 to 6 years, 107 cases aged from 7 to 14 years. Among them, there was closed craniocerebral injury in 217 cases and open craniocerebral injury in 40 cases. The Glasgow coma score revealed 13 to 15 score in 92 cases, 9 to 12 score in 62 cases, 6 to 8 score in 87 cases and 3 to 5 score in 16 cases. The craniocerebral injury was mild in 90, moderate in 57, severe in 89 and extra-severe in 21. Surgical interference was performed in 97 cases, including 62 cases of evacuation of intracra-nial hematoma with skull retain (trephine craniotomy in 14 cases),11 cases of evacuation of intracranial hemato-ma with the decompressive craniectomy, 18 cases of evacuation of intracranial hematoma with the depression fracture reduction surgery, and 6 cases of open debridement of head injury or intracranial foreign body removal surger-y. 21 patients were carried out tracheotomy. Non-surgical interference was performed in 160 cases. Results According to GOS standard, the prognostic outcome showed good recovery in 212 cases (82. 5% ) , moderate disability in 18 cases (7.0%) , severe disability in 8 cases (3.1% ) , plant survival in 2 cases (0. 8% ) and died in 17 patients (6.6%). The hospital stay duration was ranged from 11 to 195 days with an average of 11 days. 95 children were followed up for 6 months to 2 years. Traumatic epilepsy was appeared in 26 children, subdural effusion in 20 children and communicating hydrocephalus in 11 children. Conclusions The serious primary damage, severe symptom and fast pathogenetic condition development were the clinical features of craniocerebral trauma in children. The individual and standardized treatment should be emphasized in the treatment including active postoperative complication prevention and timely and appropriate combined modality therapy to reduce the mortality and morbidity. The good prognosis was easier to a-chieve in children because of better restoration ability in their nervous system.关键词
颅脑损伤/儿童Key words
craniocerebral trauma/child分类
医药卫生引用本文复制引用
陈静,石磊,刘宇,张佳兴,谷美玲..儿童颅脑损伤的临床特点及手术策略(附257例分析)[J].中国现代手术学杂志,2013,17(1):47-50,4.
