重型颅脑创伤316例临床分析

Clinical Analysis of 316 Cases of Severe Craniocerebral Injury

目的:探讨重型颅脑损伤后救治时间及GCS评分对患者预后的影响。方法:回顾分析山西省榆次市人民医院自1993年1月至2003年12月收治的316例重型颅脑外伤患者的临床资料。结果:研究组中颅脑损伤患者伤后小于3h救治者病死率25.66%,3h～24h者为37.13%,大于24h者为47.22%。随着救治时间的延长病死率呈上升趋势,各组间差异具有显著性(P<0.05)。GCS计分3分～5分颅脑损伤患者病死率为51.00%,6分～8分者为23.32%,各组间差异具有显著性(P<0.0005)。结论:重型颅脑损伤者的预后主要取决于原发伤程度,原发伤愈重GCS评分愈低,其预后愈差;伤后救治时间愈早,患者预后相应愈好。

Objective:To investigate the duration of medical aid in severe craniocerebral injury and the influence of GCS assessment on prognosis.Methods:We made a retrospective study on the data of 316 patients with severe craniocerebral injury admitted into our hospital from Jan.1993 to Dec.2003.Results:For the patients received medical aid within less than 3 hours after injury,the fatality rate was 25.66%,for those given the treatment within 3 to 24 hours,the fatality rate 37.13%,and for those had the treatment over 24 hours after injury,the fatality rate 47.22%.The fatality rate had a tendency to increase as the duration became longer.There was a significant difference between different groups (P<0.05).The fatality rate was 51.00% in patients whose GCS was 3 to 5 points and 23.22% in those whose GCS was 6 to 7 points.There was a significant difference between the groups (P<0.0005).Conclusion:The prognosis depends mainly on primary injury,the more severe primary injury is, the lower grades GCS has and the poorer the prognosis is.Earlier medical aid after injury produces better prognosis.