重型颅脑损伤合并多发伤的救治体会

Treatment experience of patients of severe craniocerebral injury combined with multiple trauma

目的探讨重症颅脑损伤合并多发伤的救治及预后。方法回顾性分析33例重症颅脑损伤合并多发伤患者的临床资料。结果 33例患者经抢救存活22例,存活率为66.7%,死亡11例,病死率为33.3%;存活者术后半年按格拉斯哥昏迷量表(GOS)评分分级为恢复良好8例(占36.4%);中度残疾5例(22.7%);重度残疾6例(27.3%),植物生存2例(9.1%),死亡1例(4.5%)。结论重症颅脑损伤合并多发伤病死率、致残率高,应早期诊断、及时抢救,正确处理危及生命的合并伤、维持重要脏器功能及术后严密监护、预防合并症对成功救治及改善预后起重要作用。

Objective To explore the treatment and prognosis of patients with severe craniocerebral injury combined with multiple trauma. Methods The data of 33 patients with severe craniocerebral injury combined with multiple trauma were analyzed retrospectively. Results After treatment, 22 patients survived and the survived rate was 66. 7% ;11 patients died and the mortality rate was 33.3%. Based on GOS score of 6 months after treatment,in 22 survived patients, good recovery were found in 8 patients （36.4%） ; moderate disability in 5 patients （22. 7% ） ; severe disability in 6 patients （27.3%） ;vegetative state in 2 patients （9. 1% ） ;one patients died （4. 5% ）. Conclusion The mortality rate and the disability rate is high in the patients with severe craniocerebral injury combined with multiple trauma. Eealy diagnosis, timely treatment, correctly handling the life-threatening associated injuries, maintai- ning the function of important organs,postoperative intensive care and prevention of complications should play an im portant role in successful treatment and prognostic improvement of patients with severe craniocerebral injury combined with multiple trauma.