veoexrmpzt
Dołączył: 21 Lut 2011
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 Wysłany: Śro 7:25, 09 Mar 2011 Temat postu: mulberry bags uon ynh pjqj kil |
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42 cases of primary brain stem injury diagnosis and treatment of
Tension increased in 8 cases, 7 cases of decerebrate rigidity, limb flaccid paralysis in 3 patients. 6 cases combined with other organ injuries. 3. Laboratory examinations: head CT examination on admission showed no obvious intracranial hematoma, brain f density anomaly (including reduced, increased, high and low mixed), brain stem thickening, deformation in 6 cases, 5 cases of diffuse axonal injury, traumatic spider l5 cases of hemorrhage under the membrane. Central pool,[link widoczny dla zalogowanych], pool quadrigemina occlusion in 12 cases,[link widoczny dla zalogowanych], fuzzy l0 cases; ambient cistern, quadrigeminal body pool exists in 20 cases. 4. Treatment: The patients taking early tracheotomy, respiratory support turns cold treatment, off of a single f: 3252 (X) Ryan. Chen Ning People's Hospital of Zhejiang Ruian ffi water, large doses of hormones and other comprehensive treatment. Heavy-duty, special mushroom-type brain stem injury cases admitted to the intensive care unit: results of the 42 cases were assessed at discharge GOS: good in 7 cases, in l0 cases of disability, severe disability in 10 cases, the survival of plants in 2 cases, death l3 cases. Central pool, four-inch stack of body pool 『J Cypriot group survived two cases, narrow the group of survivors in 8 cases, the control group survived l9 cases. Recovery of consciousness of 27 (~ 11 thousand homes an average of 35 days after the switch to clear. Discussed violence in primary brain stem injury is caused to act on the brain after head injury based F traumatic brain injury. Based on clinical manifestations, O the brain Stem divided into mild brain stem injury injury (GCS> 8 points) and severe brain stem injury (GCS ≤ 8 points). With the head CT, MRI of the widely used and found that many of the typical brain stem injury table and CT, MRI does not apparent abnormalities, or cranial CT, MRI diagnosis of brain stem injury already less so on the clinical symptoms. can be considered typical clinical symptoms, whether or not,[link widoczny dla zalogowanych], as long as the CT, MR1 support can be confirmed. severe injuries of primary brain stem injury continued after the coma. even if CT revealed no abnormalities, according to the clinical diagnosis can be. but light brain stem injury due to brain injury in a second light, limited or no significant secondary brain stem edema involving the brain or thousands of network structure , pyramidal tract and other important structures, no consciousness of early clinical symptoms are mild, it should be integrated to determine the clinical diagnosis. Some studies have shown: sustained loss of consciousness after injury, only a brain stem tissue and diffuse brain injury than re-sign, but has sustained an extraordinary awareness of brain injury changes in f, without continuing to damage the brain can not deny the coma. by this group of patients treated, we realized that: (1) For patients with light brain stem injury, should be early to judge, attaches great importance to on the possible evolution of a full estimate of the disease, timely and effective treatment to enhance dehydration,[link widoczny dla zalogowanych], control of cerebral edema secondary f, to prevent disease progression. (2) The extent of deep coma or a longer estimated duration of coma should be cut early tracheal open, in order to maintain airway patency, respiratory dysfunction, tracheostomy indications should be relaxed, early to respiratory support, correction cerebral hypoxia. hypothermia early start of formal, for a high fever, increased muscle tone or rigidity are especially important to the brain . (3) the use of dehydrating agent sufficient to control cerebral edema. application of neurotrophic drugs and vasodilators. (4) active prevention, control of complications. The group, 3 cases of atelectasis and severe lung infections, conventional treatment no significant effect, I applied bronchoscopy, lavage after the effective control of pulmonary infection; 1 case of acute renal failure, dialysis patients have been saved by timely. (5) to maintain the patient nutrition in the first week to the gastrointestinal nutrition, enteral nutrition after a week to. (6) to make dry line rehabilitation exercises and hyperbaric oxygen therapy. (7) the correct and comprehensive treatment of the emergency department is equally important. The group 1 male patients: people's homes near stop breathing , GCS4 points, by the time the emergency room endotracheal intubation, artificial respiration bag after the weak recovery of spontaneous breathing, but shallow irregular evacuation by head CT examination to the intensive care unit, tracheostomy, ventilator support, comprehensive treatment of mild hypothermia treatment After the better. primary brain stem injury mortality and morbidity is still high, but not incurable, should be the correct decision to impose a positive and effective rescue, are expected to reduce mortality and improve quality of life.
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