重型颅脑损伤后二次脑损伤的临床研究

Clinical analysis of secondary brain insults after severe craniocerebral injury

目的 探讨重型颅脑损伤后二次脑损伤（SBI）的发病规律、诊断及治疗.方法 对近4年来收治的148例重型颅脑损伤患者进行回顾性总结分析.结果 高热、低血压、低氧血症、电解质紊乱、颅内压和脑灌注压异常等SBI指标严重影响患者的预后,使患者的重残率、植物生存率及病死率显著增加（P〈0 01）.结论 高热、低血压、低氧血症、电解质紊乱、颅内压和脑灌注压异常均属于SBI指标,均直接参与了颅脑损伤的继发性病理损害.高度重视监测和严格控制SBI指标的变化.对提高颅脑伤救治水平有重要意义.

Objective To analyze the clinical features of secondary brain insults after severe craniocerebral injury. Methods The clinical data of 148 patients with severe craniocerebral injury treated in recent 4 years were analyzed retrospectively. Results The prognosis of patients was strongly influenced by hyperpyrexia, hypotension, hypoxemia, electrolyte disturbance, intracranial pressure （ICP） and cerebral perfusion pressure （CPP） abnormity. They increased significantly the severe disability rate, vegetative state rate and fatality rate （P〈0.01）. Conclusion To monitor and control the influencing factors of secondary brain insult may improvement the outcome of severe craniocerebral injury.