131 J Chin Med 13(3): 131-143, 2002 1,2 3 1 1 3 2 (2001 7 18 2001 12 11 2002 1 17 ) 28 508 1237042 89-08-13 89-11-13 I.S.S. Score 35 04-7256166 3205
132 89-08-03 89-08-03 89-09-13 1 2 89-09-28 89-10-25 189-09-30 2 389-10-16 89-11-07 89-12-04 189-11-08 2 non-contributary
133 comatose E1M4V2 (89-08-03)E4M5VT (89-08-12) anicteric OD/OS = 4/2.5 LR: /+ rebounding pain
134
135 1. HcT Hgb RBC WBC ALB K NA 890803 32.4 11.2 362 20300 2.8 144 36.8 12.3 417 17300 2.8 150 890804 41.9 14.2 481 19400 1.9 3.7 151 890805 27.8 7.9 228 5400 2.1 3.6 146 890806 30.4 10.1 342 5700 3.1 3.4 152 890807 29.1 10.2 333 6600 2.9 3.5 149 890808 32.3 11.3 374 7500 3.4 3.8 146 890809 33.8 10.1 389 10000 3.1 4.1 144 890810 33.9 11.2 388 15300 2.6 3.9 142 890811 31.1 10.9 359 15300 2.8 4.2 138 890814 27.9 9.2 362 14800 2.7 3.8 143 890821 25.9 8.4 291 14100 3.1 4.6 139 890822 29.2 9.8 327 10400 890823 30.8 10.3 348 11900 890824 23.1 7.9 264 11100 890826 26.3 8.5 299 9200 890828 27.2 9.1 312 10400 2.6 4.2 136 890904 28.6 9.3 328 9600 2.8 4.6 137 890907 30.6 9.8 349 8600
136 2. 25000 20000 Vancomycin 500 mg 8/15 ~ 8/27 15000 10000 5000 0 ER 3 4 5 6 7 8 9 10 11 14 21 22 23 24 26 28 4 7 (1) 89-08-03 Rt pneumocephalus 1 x- 1/3 open radial-ulnar fracture, D/3 Femoral shaft M/3 supracondylar fracture 2 (2) 89-08-05 Small EDH and Delay ICH with brain swelling 3 (1) Pneumocephalus (3) Small EDH Delay ICH with brain swelling
137 (2) Open radial-ulnar fracture,d/3 Femeral shaft M/3 and Supracondylar fr. 89-08-1389-09-11 89-08-13 8/3 8/3 37.4-40.2 C 8/14 3 tid 89-08-18 8/17 39
138 3 tid 89-08-21 8/21 1 3 3 3 3 3 3 3 1 3 4 3 tid 89-08-23 89-08-24 8/23 >2000ml 8/23-8/24 6U 8/23 39.5 8/24 39.3 1 8 1 3 4 2 3 4 3 3 4 tid 89-08-25 8/24 500 ml8/24 8/25 89-08-28 8/28 200-300 ml/ 8/28
139 1 1 3 4 2 3 4 3 3 3 4 tid 89-09-11 10 2 1 3 3 3 4 3 3 4 3 3 3 3 2 3 tid 89-11-1389-12-01 89-11-13 1 4 2 4 3 3 3 2 3 3 3 3 tid 89-11-14 60
140 1 4 2 8 3 3 2 2 3 3 3 3 1 3 3 3 3 tid 89-11-16 89-11-15 25ml tid 89-11-24 x 70 1 3 2 8 3 3 2 3 3 3 3 3 4 1 4 tid 89-12-01
141 90 70 89-12-4 89-8- 3 1 2 3 4 5 6 3 7,8
142 1. p.831976 2. 1996 3. 1996p.58 4. p.2891994 5. p.16111991 6. p.31975 7. Frank H. Netter. The CIBA collection of Medical illustrations, Giba-Geigy Coporation, U.S.A. Vol. 1 Nervous System, pp.90-100, 1996. 8. Julian R. Youmans. Neurological SurgeryA comprehensive reference guide to the diagnosis and management of neurosurgical problems., 3 rd edition, W.B.Saunders Co. Volume 4 pp.2554-2558, 1990.
143 J Chin Med 13(3): 131-143, 2002 TREATMENT OF BRAIN CONTUSSION AND MULTIPLE TRAUMA COMPLICATED INFECTION IN POST-OPERATION BY INTEGRATED CHINESE AND WESTERN MEDICINE Jung-Chou Chen 1,2, Fu-Hwa Wang 3 and Wei-Che Li 1 1 Department of Chinese Medicine, 3 Division of Neurosurgery, Show Chwan Memorial Hospital Changhua, Taiwan 2 China Medical College, School of Chinese Medicine Taichung,Taiwan (Received 18 th July 2001, revised Ms received 11 th December 2001, accepted 17 th January 2002) This is a multiple trauma case of brain contusion with intracranial hemorrhage and loss of consciousness, thoraxic rib and right tibial fracture, as well as right ulna-radial and both femoral open fracture. The patient was admitted via emergency and received craniotomy, right thigh debridement and fixed operation of bone fracture. Unfortunately he suffered from infectious complication with high fever and osteomyelitis in post-operation. The patient s condition was stabilized under combined treatment of Chinese medicine and Western Medicine. He was admitted and discharged hospitalization for three times. The recovery condition of bone fracture in postoperative rehabilitation and acupuncture treatment was very well. The complicated osteomyelitis also had complete remission. Key words Multiple trauma, Brain contusion, Intracranial hemorrhage, Open fracture and osteomyelitis. Correspondence to: Jung-Chou Chen, Department of Chinese Medicine, Show-Chwan Memorial Hospital, Changhua, Taiwan. TEL: 04-7256166*3205