《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (09): 871-872.

• 临床观察 • 上一篇    下一篇

34例重型颅脑损伤患者伤后并发急性精神障碍的临床分析

张广平1;赵尚峰2;傅继弟2   

  1. 1.首都医科大学附属北京安定医院,北京市 100088;2.首都医科大学附属北京同仁医院颅面创伤中心,北京市 100176
  • 收稿日期:2009-06-22 出版日期:2009-09-01 发布日期:2009-09-01
  • 通讯作者: 傅继弟

Acute Mental Disorders after Severe Traumatic Brain Injury: 34 Cases Report

ZHANG Guang-ping,ZHAO Shang-feng,FU Ji-di   

  1. Anding Hospital, Capital Medical University, Beijing 100088, China
  • Received:2009-06-22 Published:2009-09-01 Online:2009-09-01

摘要: 目的 分析重型颅脑损伤患者伤后并发急性精神症状的临床表现和治疗。方法 对34例重型颅脑损伤并发精神障碍患者进行回顾性分析。结果 34例颅脑损伤患者均早期出现精神障碍,其中躁狂样表现15例;抑郁样表现7例;类精神分裂症样表现2例;痴呆样表现10例。颅脑损伤部位为额叶、颞叶、额颞叶、枕叶、弥漫性轴索伤和脑干损伤。2~7周后痊愈26例(76.5%);3个月复查痊愈31例(91.1%);2例弥漫性轴索伤和脑干损伤6个月后随访,痴呆型精神障碍无明显改善。结论 颅脑损伤后出现急性精神障碍是神经外科治疗常见的临床问题,早期进行精神专业医师的干预,并依据患者的症状给予个体化治疗,能够取得较好的疗效。

关键词: 重型颅脑损伤, 精神症状, 临床表现, 治疗

Abstract: Objective To analyze the clinical features and treatment of the acute mental disorders after severe traumatic brain injury.Methods 34 cases were analyzed retrospectively. Results All the patients presented mental disorders early. There were maniac in 15 cases, depression in 7 cases, schizophrenia in 2 cases and dementia in 10 cases. The focus of brain injury includes frontal lobe, temporal lobe, frontal-temporal lobe, occipital lobe, diffuse axonal injury and the brain stem injury. 26 (76.5%) cases were cured when discharged and 31 (91.1%) cases cured after 3 months. 2 cases of diffuse axonal injury and brain stem injury with dementia did not improve after 6 months follow-up. Conclusion Mental disorders are common complications after traumatic brain injury. Early intervention from psychiatry and the individual treatment would cause a satisfied outcome.

Key words: severe traumatic brain injury, mental disorder, clinical feature, treatment