| 岳景齐，钟志坚，孙海鹰，田登攀，王建荣.重型颅脑损伤合并颅颈交界伤的临床分析.[J].中南医学科学杂志.,2013,41(1):51-53. |
| 重型颅脑损伤合并颅颈交界伤的临床分析 |
| Clinic Analysis of Severe Craniocerebral Injury Combined With Craniovertebral Junction Injury |
| 投稿时间：2012-10-08 |
| DOI： |
| 中文关键词: 颅脑损伤 颅颈交界伤 早期诊断 治疗 |
| 英文关键词:craniocerebral injury craniovertebral junction injury early diagnosis treatment |
| 基金项目: |
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| 中文摘要: |
| 目的总结重型颅脑损伤合并颅颈交界伤的临床特点，探讨重型颅脑损伤合并颅颈交界伤的早期诊断和治疗方法。方法回顾性分析37例重型颅脑损伤合并颅颈交界伤患者的一般资料、临床特征、诊治方法及疗效。结果37例患者确诊时间3 h～14天，颅颈交界伤漏诊6例，颅脑损伤漏诊1例。出院时GOS预后评定结果显示，Ⅰ级10例，Ⅱ级6例，Ⅲ级4例，Ⅳ级8例，V级9例。经积极治疗后，生存22例，生存率59.5%；死亡15例，死亡率40.5%。结论根据致伤原因和临床表现，在头颅CT检查的同时常规行颈椎CT平扫、颈椎螺旋CT三维重建，病情稳定后及时行头颅、颈椎MRI，可提高早期诊断率，降低漏诊率。在颈部制动的前提下，先处理颅脑和其他危及生命的损伤，待病情稳定后再处理颅颈交界伤，可提高生存率和治疗水平。 |
| 英文摘要: |
| ObjectiveTo summarize the clinical characteristics of severe craniocerebral injury combined with craniovertebral junction injury,in order to explore early diagnosis and therapeutic method on this kind of disease.MethodsThe general information,clinical features,diagnosis,treatment and curative effect of 37 patients were retrospectively studied.ResultsPost-injury 3 h ～ 14 d,37 patients were diagnosed,6 cases of craniovertebral junction injury and 1 case of craniocerebral injury was missed diagnosis.22 patients survived with the survival rate of 59.5% and 15 patients died with the mortality rate of 40.5% through active treatment.According to Glasgow Outcome Scale,10 cases were of Grade Ⅰ,6 of Grade Ⅱ,4 of Grade Ⅲ,8 of Grade Ⅳ and 9 of Grade Ⅴ.ConclusionsAccording to the injury causes and clinical manifestation,the patients should receive head CT examination and cervical vertebra CT scan and cervical vertebra spiral CT three-dimensional reconstruction at the same time.In stable condition，MRI examinations of head and cervical vertebra also should be performed in time,which can improve the early diagnosis rate,reduce the missed.In the neck brake premise,craniocerebral and other life-threatening injury should be treated first,Once in stable condition，followed by treating craniovertebral junction injury,which can improve,which survival rate and treatment level. |
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