儿童重型颅脑损伤的临床特点及针对性的治疗措施

CLINICAL CHARACTERISTICS OF SEVERE CEREBRAL TRAUMA IN CHILDREN AND PERTINENT TREATMENT

目的:分析儿童重型颅脑损伤的临床特点及针对性的治疗措施。方法:用统计学方法分析各种危险因素对预后的影响。结果:62例患儿,死亡17例(27.42%),预后与原发性损伤的严重程度有关,GCS评分5～8分者存活41例,存活率89.13%,而GCS评分<5分者存活6例,存活率37.50%。外伤后弥漫性脑肿胀、脑水肿(P<0.0001)是影响预后的主要因素。结论:儿童颅脑损伤后,对颅内高压的耐受性差,病情变化快。神智、瞳孔和GCS评分的严密观察及CT的动态观察是判断伤情的关键。ICP监测在治疗中具有重要意义。

Objective：To analyze the clinical characteristics of severe cerebral trauma in children and pertinent treatment.Methods：the influences of various risk factors on the prognoses were analyzed by statistics .Resuits：Among the 62 children with severe cerebral trauma,17（27.42%）died .The degree of primary trauma influnced the prognoses.41patients with GCS between 5 and 8 survived,the survival rate was 89.13%,whereas 6 patients with GCS lower than 5 survived,the survival rate was 37.50% .Diffuse cerebral swelling and cerebral edema after trauma was an major risk factor influencing the prognoses.Conclusion：After craniocerebral injury children＇s tolerance on intracranial hypertension is poor and the change of the patient＇s condition is rapid . Close observation of mind,pupil and GCS scoring and dynamic observation of CT is key to judge the injury conditions .During treatment , ICP monitoring has important clinical significance .