重型颅脑损伤脑疝的救治与预后

The treatmen and prognosis of severe craniocerebral trauma followed by brain hemia

目的总结重型颅脑损伤脑疝的救治经验,探讨脑疝与预后的关系。方法对134例脑疝患者的救治进行回顾性分析。结果134例患者中存活76例(56.7%),根据格拉斯哥预后评分(GOS),恢复良好45例,中残17例,重残14例,死亡58例(43.3%)。结论及时正确的院前急救和院内处理,维持呼吸道通畅及稳定循环是救治的重点,手术是抢救脑疝患者的关键,应用消除脑水肿、促进神经和功能恢复的药物是改善预后必不可少的措施。

Objective To summarize the clinical experiences of the severe craniocerebral Trauma with brain hernia. To investigate the relations between the prognosis and the brain hernia. Methods 134 cases of brain hernia admitted to our hepartmment from January 1993 to May 2005 were analyzed retrospectively. Many possible etiological factors were summarized, The curative effects of many kinds of treatment were compared. Results Of 134 patients with severe cranioeerebral trauma, 76 patients were survived（56.7 % ） and all the cases were evaluated with GOS at discharge：45 cases were satisfactorily recorved, 17 cases were moderate disability, 14 cases were severe deficts, 58 cases（43.3 % ） died. Conclusions Keeping the air way clear and circulation stabilization, pre-hospital and hospitalization Treatment in time and operation are the necessary features to improve prognosis. Using medicine that can remove brain edema,stimulate the mind and function recover is also the absolutely necessarily feature.