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小儿由于解剖学、生理学方面与成人不同,因而小儿颅脑损伤后病理、生理变化、临床表现及治疗均具有其特殊性。现就近年来收治的32例小儿颅脑损伤的诊断和治疗分析如下。1 临床资料32例患儿年龄最大13岁,最小者2岁;男24例,女8例。临床诊断脑挫裂伤14例,其中疑有颅内血肿10例,颅骨凹陷性骨折6例,开放性颅脑损伤(脑组织外溢)4例,脑震荡8例。经X线检查证实有颅骨凹陷骨折6例,额骨粉碎性骨折4例。32例均做脑超声波检查,仅有6例有中线波偏移,术中证实为硬脑膜下血肿。32例均有原发性意识障碍,其中10例由原发性意识障碍呈进行性加重,其余22例均于伤后24小时内清醒,伤后呕吐,发热,脉搏加快,呼吸浅表,嗜睡18例,有癫痫发作者6例。
Pediatric anatomy, physiology and adults are different, so children with traumatic brain injury pathology, physiological changes, clinical manifestations and treatment have their own particularity. Now in recent years admitted to 32 cases of children with brain injury diagnosis and treatment are as follows. 1 Clinical data 32 cases of children aged 13 years, the youngest 2 years; 24 males and 8 females. Clinical diagnosis of cerebral contusion in 14 cases, of which suspected intracranial hematoma in 10 cases, skull fracture in 6 cases, open brain injury (brain tissue spill) in 4 cases, concussion in 8 cases. X-ray examination confirmed skull fracture in 6 cases, frontal comminuted fracture in 4 cases. All 32 patients underwent echocardiography. Only 6 patients had midline wave excursions. Intraoperative subdural hematoma was confirmed. 32 cases had primary disturbance of consciousness, of which 10 cases were progressive aggravated by the primary disturbance of consciousness, the remaining 22 cases were awake within 24 hours after injury, vomiting after injury, fever, pulse, superficial breathing, lethargy 18 cases, 6 cases of seizures.