Clinical analysis of 37 patients with bilateral frontal lobe contusion / 中国基层医药

ABSTRACT

Objective:To investigate the treatment methods and their efficacy for bilateral frontal lobe contusion.Methods:The clinical data of 37 patients with bilateral frontal lobe contusion who received treatment in Fujian Provincial Hospital between May 2017 and May 2018 were analyzed. The 37 patients were divided into surgical group ( n = 19) and non-surgical group ( n = 18) according to different treatment methods. Clinical efficacy was compared between the two groups. All patients underwent intracranial pressure monitoring. Intracerebral pressure was divided into three stages < 20 mmHg, 20-40 mmHg, > 40 mmHg. Clinical efficacy was compared among patients with different levels of intracranial pressure. Results:In the surgical group, one patient died, one patient was in a vegetative state, two patients had severe disability, eight patients had mild disability, and seven patients well recovered. In the non-surgical group, four patients died, three patients were in a vegetative state, six patients had severe disability, three patients had mild disability, and two patients well recovered. There was significant difference in good recovery rate between the two groups ( χ2 = 9.83, P < 0.05). The good recovery rate was statistically significant among patients with different levels of intracranial pressure ( χ2 = 7.97, P < 0.05). The vegetative state rate in patients with > 40 mmHg intracranial pressure was significantly higher than that in patients with < 20 mmHg intracranial pressure (50.0% vs. 0.0%, χ2 = 7.65, P < 0.05). The good recovery rate in patients with > 40 mmHg intracranial pressure was significantly lower than that in patients with < 20 mmHg intracranial pressure (0.0% vs. 61.5%, χ2 = 7.57, P < 0.05). Conclusion:The choice of treatment for bilateral frontal lobe contusion mainly depends on clinical symptoms, dynamic brain CT findings, and the changes in dynamic intracranial pressure monitoring. Active surgery can reduce the incidence of death and severe disability. Intracranial pressure monitoring has a positive role in guiding clinical treatment.