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目的探讨外伤性急性脑肿胀患者的CT分型及治疗方法。方法对72例外伤性急性脑肿胀患者,根据其24h内CT征象中线结构是否移位>5mm为标准,分为A、B、C三组:一侧半球脑肿胀,但中线移位≤5mm为A组;中线移位>5mm为B组;双侧半球弥漫性脑肿胀,不论中线是否移位为C组,分析治疗效果。结果A、B和C三组患者手术生存率分别是78.6%、76.2%和40.0%。A、B组和C组比较差异有统计学意义(P<0.05);A、B组手术与非手术生存率为77.1%和38.4%(P<0.05);C组手术与非手术生存率为40%和33.3%,差异无统计学意义(P>0.05)。结论根据CT分型选择不同的治疗方式及恰当的手术时机是提高TABS生存率的关键。
Objective To investigate CT classification and treatment of patients with traumatic acute brain swelling. Methods 72 patients with traumatic acute brain swelling were divided into A, B and C groups according to whether their midline structures were displaced by> 5 mm within 24 hours: one side of the hemisphere was swollen, but the median shift was ≤5 mm Group A; central line shift> 5mm for Group B; bilateral hemispheric diffuse brain swelling, regardless of whether the median shift for the C group, analysis of treatment. Results Survival rates of A, B and C patients were 78.6%, 76.2% and 40.0% respectively. There was significant difference between A, B and C groups (P <0.05). Surgical and non-surgical survival rates in group A and B were 77.1% and 38.4% (P <0.05) respectively. Surgical and non-surgical survival rates in group C were 40% and 33.3%, the difference was not statistically significant (P> 0.05). Conclusions Choosing different treatment methods and proper operation timing according to CT classification is the key to improve the survival rate of TABS.