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中华神经创伤外科电子杂志 ›› 2020, Vol. 06 ›› Issue (04) : 229 -232. doi: 10.3877/cma.j.issn.2095-9141.2020.04.008

所属专题: 文献

临床研究

儿童外伤性脑梗死的诊断与治疗
张桂玲1, 张怀强1, 王洪生2,(), 孙印臣2, 赵佩林2, 王志明2, 孟文博2   
  1. 1. 075000 张家口,解放军陆军第八十一集团军医院儿科
    2. 075000 张家口,解放军陆军第八十一集团军医院神经外科
  • 收稿日期:2020-06-03 出版日期:2020-08-15
  • 通信作者: 王洪生

Diagnosis and treatment of traumatic cerebral infarction in children

Guiling Zhang1, Huaiqiang Zhang1, Hongsheng Wang2,(), Yinchen Sun2, Peilin Zhao2, Zhiming Wang2, Wenbo Meng2   

  1. 1. Department of Pediatrics, The Hospital of 81 Group Army PLA, Zhangjiakou 075000, China
    2. Department of Neurosurgery, The Hospital of 81 Group Army PLA, Zhangjiakou 075000, China
  • Received:2020-06-03 Published:2020-08-15
  • Corresponding author: Hongsheng Wang
  • About author:
    Corresponding author: Wang Hongsheng, Email:
引用本文:

张桂玲, 张怀强, 王洪生, 孙印臣, 赵佩林, 王志明, 孟文博. 儿童外伤性脑梗死的诊断与治疗[J/OL]. 中华神经创伤外科电子杂志, 2020, 06(04): 229-232.

Guiling Zhang, Huaiqiang Zhang, Hongsheng Wang, Yinchen Sun, Peilin Zhao, Zhiming Wang, Wenbo Meng. Diagnosis and treatment of traumatic cerebral infarction in children[J/OL]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2020, 06(04): 229-232.

目的

分析不同类型的外伤性脑梗死患儿的治疗方案,结合文献探讨其发病机制,以提高其治愈率,降低致残率。

方法

回顾性分析解放军陆军第八十一集团军医院自2015年1月至2019年12月收治的42例外伤性脑梗死患儿的临床资料。采用头颅CT扫描和MRI诊断儿童外伤性脑梗死,根据不同病情将儿童外伤性脑梗死进行诊断分型,选择不同的治疗方案。腔隙性脑梗死患儿给予钙拮抗剂和神经营养药物治疗,并辅以高压氧、运动康复治疗;局灶型脑梗死、混合型脑梗死患儿除应用钙拮抗剂和神经营养药外,还应用小剂量脱水剂和小剂量激素,并随病情演变随时调整治疗方案;大面积脑梗死的患儿,急诊行去骨瓣减压术,术后给予降颅压、预防并发症等综合治疗。观察患儿的治疗结果及恢复情况。

结果

42例外伤性脑梗死患儿中,恢复良好35例(83.3%),中残4例(9.5%),重残2例(4.8%),死亡1例(2.4%),无植物生存。腔隙性脑梗死的恢复良好率为100%,局灶型脑梗死的恢复良好率为62.5%,混合型脑梗死的恢复良好率为60%,大面积脑梗死的恢复良好率为50%。

结论

针对不同类型的脑梗死患儿采用不同的治疗方案,对提高儿童外伤性脑梗死的治疗效果、改善预后意义重大。

Objective

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

Methods

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

Results

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

Conclusion

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

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