以颅脑损伤为主的多发伤急救中心一体化救治探讨(附148例报道)

Integrative treatment of multiple trauma patients with severe craniocerebral injury in emergency center (with 148 cases report)

目的探讨以颅脑损伤为主的多发伤急救中心一体化救治的意义及重要措施。方法回顾性分析2002年11月～2006年2月收治的148例颅脑损伤合并多发伤患者的临床资料。结果死亡26例，植物生存状态7例，重残17例，轻残26例，痊愈72例。结论颅脑损伤合并多发伤往往伤情严重，变化快。此类患者必须由急救中心医师组织实施救治，边抢救边诊断。首先处理危及生命的损伤，及时纠正休克，是抢救成功的关键。手术时机的选择，尤其是行多发伤一期手术，脏器功能的监测和保护，注意营养支持，是提高抢救成功率的重要措施，而且急诊ICU在多发伤救治中起到重要作用。

Objective To explore the significance and important measure of integrative treatment of multiple trauma patients with severe craniocerebral injury in emergency center. Methods One hundred and forty - eight multiple trauma patients with severe craniocerebral injury in emergency center from November 2002 to February 2006 were analysed retrospectively. Result In total 148 cases, 72 were cured and 26 dead, 7 were in status of plant man, 17 experienced severe deformity, and 26 did mild deformity. Conclusion Multiple trauma patients with severe craniocerebral injury usually experience a serious situation and rapid development. Therefore emergency doctors are required for organizing salvage of such patients, at the same time treatment and diagnosis are implemented. Firstly the most important key to successful salvage is appropriate disposal of fatal injury and early elimination of shock. Proper surgical choice, especially at the first time, inspection and protection of visceral functions, and attention to nutritional support are other vital methods to gain more successful salvage. ICU is also emphasized for its essentiality.