脑外伤继发性功能障碍临床分析与护理

Brain flesh wound sequential function barrier clinical analysis and nurses

目的：探讨脑外伤继发性多器官功能障碍的发病机制、治疗方法和临床护理.方法：回顾性分析2003年3月～2006年3月来我院收治的脑外伤继发多器官功能障碍综合征患者52例的临床资料.结果：206例脑外伤患者中死亡84例,病死率40.78%.出现多器官功能障碍综合征52例中死亡3例,病死率5.77%;154例未出现多器官功能障碍综合征者死亡54例,病死率35.06%（P＜0.01）.2个器官衰竭的病死率为56.67%（17/30）,3个器官衰竭的病死率71.43%（10/14）,4个以上器官衰竭和伴有凝血障碍者全部死亡（8/8）.35例具有肺功能障碍者中死亡30例,病死率85.7%,明显高于其它组.无因护理措施不当而导致脑损伤继发各器官功能障碍患者死亡.结论：及时有效地缓解颅高压、恢复脑干功能是治疗的首要问题;而肺部继发症的合理治疗是控制多器官功能障碍综合征的重要环节;综合救治策略仍然是降低病死率的关键手段.

Objective：Discussion brain flesh wound secondary multi--organ function barrier pathogcnesis, method of treatment and clinical nursing. Methods：The review analysis in March,2003-2006 years in March came my courtyard admitting the brain flesh wound to continue sends the multi--organ function barrier synthesis to draft the patient 52 examples the clinical materials. Results：In 206 example brain flesh wound patient died 84 examples,the case fatality rate 40.78%. Appears the multi--organ function barrier synthesis to draft in 52 examples to die 3 examples,the case fatality rate 5.77% ;154 examples have not appeared the multi--organ function barrier synthesis drafting death 54 examples,the case fatality rate 35. 06% （P〈0.01）. 2 organ failure case fatality rate is 56.67%（17/30） ,3 the organ failure case fatality rate 71.43%（10/14） ,4 above organ failure and is accompanied by the hemoglutination barrier to die completely（8/8）. 35 examples have in the lung function barrier to die 30 examples,the case fatality rate 85.7% ,is higher than other groups obviously. Does not have because of the nursing measure not when causes the brain damage to continue sends various organs function barrier patient to die. Conclusion： Effectively alleviates the skull high pressure, restores the brain stem function is promptly the treatment most important question; But the lungs sequela reasonable treatment controls the important link which the multi--organ function barrier synthesis drafts;The synthesis treated and cured the strategy still was reduces the case fatality rate the essential method.