Clinical analysis and treatment strategy of cerebral contusion in children / 天津医药

ABSTRACT

Objective To study the clinical characteristics of brain contusion in children and discuss the corresponding treatment strategies.Methods From February 2013 to December 2017,the clinical data of 32 patients(aged 1-14 years)with cerebral contusion and treated in the department of brain of the affiliated hospital of armed police logistics college were collected,including 22 males and 10 females.The age of patients ranged from 1 to 13.5 years,with the average of(6.03 ± 3.96)years.Patients were divided into low age group(1-4 years old,n=14)and high age group(5-14 years old,n=18)according to their age.Data of the brain damage location and distribution,Glasgow Coma Scale(GCS)/Children's Coma Scale (CCS), intracranial pressure (ICP), cerebral edema, airway condition, traumatic epilepsy and electroencephalogram (EEG) were summarized and analyzed. Results The duration of hospitalization was 17-57 d, with the average of (34.2 ± 11.5)d.All the children were treated with hyperbaric oxygen for 14-51 d,with an average of(36.1±5.1)d.There were no significant differences in the depth of brain damage and the location of brain injury between the two age groups(P>0.05). The coma scores at the admission and the discharge were significantly lower in low age group than those of the high age group (P<0.05). The duration of ICP monitoring was 6-15 d, with the average of (7.5±2.0) d. The ICP level and the resonance index(RI)value of cerebral edema monitoring at the admission was higher in the low age group than those in the high age group(P<0.05).The abnormal time of RI was less in the low age group than that in the high age group(P<0.05).There were no significant differences in seizures and EEG classification between two groups (P>0.05). There were 10 cases in each group received the transnasal intubation,and the average days with intubation were longer in the low age group than those of the high age group(P<0.05).Conclusion The clinical manifestations,imaging features,ICP,the degree of brain edema, seizures and airway management in children of different ages are different. The treatment should be carried out as soon as possible,actively and comprehensively,especially in the clinical management for the children of low age.