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目的:讨论清醒后额叶脑挫裂伤并脑内血肿手术时机及手术目的,分析引起临床风险的病因病理。方法:取2001-08/2009-07山东青岛开发区第一人民医院共计30例早期手术患者及3例保守治疗患者临床资料,分析治疗结果及风险。结果:早期手术治疗组患者恢复良好29例,死亡1例。保守治疗组突发脑疝1例,死亡1例,治愈1例。结论:有相对手术指征的未昏迷额叶脑挫裂伤患者,早期手术治疗效果满意。丘脑下部迟发损伤为导致患者不良预后的早期最重要原因。
OBJECTIVE: To discuss the timing of surgery and the purpose of surgery for cerebral contusion and laceration of the frontal lobe after awake, and to analyze the etiology and pathology of the clinical risk. Methods: The clinical data of 30 cases of early surgery and 3 cases of conservative treatment in the First People’s Hospital of Qingdao Development Zone in Shandong from August 2001 to July 2009 were analyzed, and the treatment outcome and risk were analyzed. Results: In the early surgery group, 29 cases recovered well and 1 died. Conservative treatment group, sudden hernia in 1 case, 1 died, 1 case cured. CONCLUSIONS: Patients with unconscious frontal lobe contusion and laceration with relative surgical indications were satisfied with early surgical treatment. Delayed subthalamic injury is the leading cause of poor prognosis in patients with the most important reason.