急性重型颅脑伤的治疗结果分析

Analysis of the Outcome from Severe Acute Head Injuries

本文对连续94例急性重型颅脑外伤的治疗结果进行了分析,这些病例均用GCS计分评定,属7分及7分以下至少6小时。全组死亡率为37.2%。相同计分不同病变其后果各异,说明评定重型颅脑外伤除用GCS计分外.应增加其它条件。伤后4小时内手术者较以后时间手术的病例死亡率高。大于40岁者比小于40岁者死亡率高。

The outcomes of 94 consecutive cases of severe acute head injuries were analyzed. The severity of the patients were catagorized according to the Glasgow Scale （GCS）. All were GCS≤7 for at least 6 hours, and were diagnosed and managed according to the same uniform protocal. There were 25 cases with extradural bematoma, 31 subdural hematoma, 8 intracerebral hematoma and 30 contusion-laeeration of the brain Overall mortality of this series was 37.2%, but those patients with the same GCS score caused by different lesion catagories might have different ontcomes. The present analysis shows also that for the evaluation of the outcomes from severe acute head injuries, some other relevant factors should also be considered besides the GCS score Those who were operated upon earlier, within 4 hours after injury, actually bad a bigber mortality than those who were operated upon later than that, mainly because of the fact that these patients were inflicted with even severer injuries and deserved more urgent operations Mortality was also higher among those above 40 years of age owing to that there are less ability to cope with severe trauma and decreased compensatory reserve of vital functions.