颅脑损伤合并多发伤的临床分析

Clinical treatment on craniocerebral injury with multiple trauma

目的探讨颅脑损伤合并多发伤的临床救治原则和处理。方法采集本科2006年4月至2009年2月入院的169例重症颅脑损伤合并多发伤患者进行临床资料研究,并对其救治过程进行回顾性分析。结果患者术后依照格拉斯哥结局量表GOS评分恢复良好65例(38.5%),轻残48例(28.4%),重残21例(12.4%),植物生存5例(3.0%),死亡30例(17.8%)。结论合理救治程序至关重要,重视院前急救和术后综合治疗,强调先重后轻,先开放后闭合的救治原则。早诊断早治疗能提高重型颅脑损伤合并多发伤的治疗效果,同时是减少致残率及降低死亡率的最佳选择。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 discuss and summarize the clinical characters and treatment for multiple injury with head injury patients. Methods 169 eases of severe head injury with multiple injury patients in hospital from April ,2006 to Febrary, 2009 were retrospectively analysed. Their clinical materials had been involved. Results After treatment, the effect had been evaluated by Glasgow outcome scale （GOS）. 65 patients were under good condition （ 38.5% ）, 48 cases were light disability （ 28.4% ）. 21 cases were severe disability （ 12.4% ） and 30 cases were dead（ 17.8% ）. Conclusion The keys of successful treatment are earIy diagnosis, early treatment, dealing with the fatal injuries firstly, avoiding mis-diagnosis, using special treatment and monitoring in ICU.