[1]魏民,董伦,张恒柱,等.开放性颅脑损伤合并异物嵌插的诊断与治疗[J].临床神经外科杂志,2016,(04):289-292.
 WEI Min,DONG Lun,ZHANG Heng-zhu,et al.Experiences in the diagnosis and treatment of open traumatic brain injury and rare cases embodded foreign objects[J].Journal of Clinical Neurosurgery,2016,(04):289-292.
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开放性颅脑损伤合并异物嵌插的诊断与治疗()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
期数:
2016年04期
页码:
289-292
栏目:
论著
出版日期:
2016-07-26

文章信息/Info

Title:
Experiences in the diagnosis and treatment of open traumatic brain injury and rare cases embodded foreign objects
作者:
魏民董伦张恒柱严正村佘磊王晓东王杏东陈浪
225001 扬州,江苏省苏北人民医院神经外科
Author(s):
WEI Min DONG LunZHANG Heng-zhuet al.
Department of Neurosurgery, Jiangsu Province Southern Hospital, Yangzhou 225001, China
关键词:
颅脑损伤 开放性异物 治疗
Keywords:
traumatic brain injury foreign objects craniocerebral trauma
文献标志码:
A
摘要:
目的:探讨开放性颅脑损伤合并异物嵌插的诊治方法。方法:回顾性分析4例开放性颅脑损伤合并异物嵌患者的临床资料,总结诊治经验。治疗以变开放性损伤为闭合性损伤为原则,术后加强抗感染,预防癫痫发作。假性动脉瘤形成的高危患者早期进行处理。结果:1例异物刺入颅内假性动脉瘤形成患者,经异物拔除术及动脉瘤栓塞术后生命体征稳定,但意识模糊。右颅眶树枝嵌插伤患者经手术治疗神志清楚,左侧视力、瞳孔光反射正常,右侧视力眼前2米指数。重度开放性脑损伤患者术前昏迷,术后神志清楚,左侧视力正常。1例石弩弓箭贯通伤患儿予以保守治疗,出院时患儿肌肉萎缩、肌力Ⅳ级,神志清楚,恢复可。结论:因外伤所致开放性颅脑损伤合并异物嵌插的类型各异。对头皮损伤者必须追问相关病史、完善影像学检查,必要时外科探查避免漏诊。异物残留患者必须清除异物及挫伤脑组织,闭合开放性损伤。对合并颌面部多发损伤患者可多科室合作,注意抗感染及预防癫痫发作。只有诊断明确、治疗恰当,才能提高疗效、缩短疗程、预防意外情况的发生。
Abstract:
Objective:To preliminarily investigate the attributes of transcranial embodded foreign objects and the treatment approaches.Methods:The clinical data and treatment procedures were retrospectively examined in 4 cases with craniocerebral trauma caused by open craniocerebral injury. In principle, the treatment was performed to change the open injury to close craniocerebral injury. Anti-infection, prevention of epilepsy, pseudoaneurysm after proper surgical therapy in time could be helpful for the patients successfully cured. Results:Case 1 got injuried with transcranial embodded foreign objects and pseudoaneurysm. The patient underwent surgical and embolization was awareness of fuzzy. Case 2 suffered from the embodded tree-branch in the right eye socket. After interventions the patient could see clearly within 2 miles by the right eye with sanity. Case 3 was severe traumatic brain injury with insensible awareness. The patient got recovered of left insight after operation. Case 4 was a child injured by arrow of catapult. Conclusion:Patients by traumatic brian injury with embedded foreign objects could be serious and the conditions may be varies. In order to prevent misdiagnosis, CT or CTA scan, injury history, and surgery explore may be helpful. After procedure, prevention of the intracranial infection and anti-epilepsy is recommended. The patients may be cured if they could obtain an early diagnosis and correct treatment.

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备注/Memo

备注/Memo:
江苏省六大人才高峰(WSN-022);江苏省333工程项目(BRA2012094);江苏省中医药局科技项目(LZ13195)
更新日期/Last Update: 2016-08-10