重型颅脑损伤患者死亡原因分析及应对策略

Clinical analysis and strategy of management for the patients died of severe brain injury

目的 回顾性研究总结重型颅脑损伤的死亡原因和救治经验。方法 分析GCS 3～ 8分的 4 83例重型颅脑损伤病人的伤情、处理措施和预后。结果 重型颅脑损伤的死亡率为 2 8% ,其中GCS 6～ 8分为15 % ,3～ 5分 5 6 % ,严重脑裂伤、脑肿胀和合并并发症为死亡的主要原因。结论 早期诊断、早期处理 ,有效降低颅内压和防治并发症是降低死亡率的三大主要措施 ;强调动态CT复查和去骨瓣减压术的重要性。

Objective To explore the causes of death from severe brain injury and summarize management experience.Methods A total of 483 cases with severe brain injury in recent 13 years were analyzed in regard to the degree of trauma,the management,and progosis.Results The mortality rate was 28% in all patients,while 15% in the patients of GCS 6～8 and 56% in the patients of GCS 3～5 respectively.The deaths were mainly caused by massive brain contusion,diffuse brain swelling,complication and associated injuries.Conclusion Early diagnosis and timely treatment are as well as effective management of complication essential measures to lower mortality rate.CT scan followed by continuous observation,and decompressive craniotomy are important in the management of severe brain injury.