重型颅脑损伤3160例临床救治经验总结

TREATMENT OF SEVERE CRANIO-CEREBRAL INJURY: A REPORT OF 3160 CASES

为探讨重型颅脑损伤有效的治疗手段与方法 ,以提高治愈率 ,降低病死率 ,回顾性研究了 316 0例患者的致伤原因、损伤类型、抢救措施、手术方式及预后状况。结果发现 ,致伤原因主要为交通伤和坠落伤 ;损伤类型多为硬膜下血肿 ,其次为硬膜外和多发性血肿 ;临床征象主要是意识障碍、锥体束征和瞳孔改变 ;治愈好转率达73 6 % ,病死率 19 4%。作者认为早期诊断、保持呼吸道通畅、及时手术、术中注意保护脑组织和术后加强监护是使该类病人获得康复的重要措施。

Through a retrospective clinical analysis of 3160 cases of severe cranio cerebral injury ( SCCI ), the aim of this study is to explore effective treatments to increase cure rate for this injury. The causes and types of trauma, operation modalities,and prognosis were reviewed. The main causes resulting in SCCI were traffic accidents and fall from a height. The main types of SCCI were subdural, extradural and multiple intracranial hematomas. The main signs and symptoms were unconsciousness, pyramidal signs and pupil changes. The rate of cure and improvement was 73 6%. The mortality rate was 19 4%. Early diagnosis and timely operation, maintenance of patency of the respiratory tract, brain protection during operation, and competent ICU care after operation were important measure to achieve good recovery of SCCI patients.