148例重型颅脑损伤合并多发伤的治疗

Treatment experience of 148 patients with severe craniocerebral injuries combined with multiple trauma

目的评估重型颅脑损伤合并多发伤的救治结果。方法回顾性分析148例重型颅脑损伤合并多发伤的临床资料,总结重型颅脑损伤合并多发伤的治疗方法。结果148例全部行开颅手术治疗,其中90例同时或先后行多发伤手术治疗。伤后半年按格拉斯哥结局量表(GOS)分级:良好47例,占32%;中度残疾34例,占23%;重度残疾18例,占12%;植物状态3例,占2%;死亡46例,占31%。结论重型颅脑损伤合并多发伤应早期诊断,及时抢救,避免漏诊和误诊,首先处理危及生命的损伤以及专科治疗配合ICU监护是重型颅脑损伤合并多发伤救治成功的关键。

Objective To evaluate the therapeutic effects of the patients with severe craniocerebral injuries combined with multiple trauma. Methods The clinical data of 148 patients with severe craniocerebral injuries combined with multiple trauma were analyzed retrospectively,and the treatment experiences were summarized. Results All of the 148 cases underwent craniotomy,and 90 of them underwent operation for multiple trauma at the same time or early or late. In this series, the assessment of outcome： 47 patients were good recovery,34 patients were moderate deficit,18 patients were severe deficit,3 patients were vegetative state,46 patients were dead. Conclusion The keys of successful treatment are early diagnosis, early treatment, dealing with the fatal injuries firstly,avoiding misdiagnosis, using special treatment and monitoring in ICU.