以颅脑伤为主的全身多发伤快速急救探讨

Emergency management of cranial injury with multiple trauma

目的：探讨以颅脑伤为主的全身多发伤快速急救的意义及重要措施。方法：回顾性分析总结１９９１年５月～１９９７年６月７２８例多发伤快速急诊救治的资料。结果：以颅脑伤为主的全身多发伤，最多见于２０～４５岁青壮年，占８０％。死亡５５例中，重型颅脑伤伴顽固性休克死亡者最多，共３６例；脑死亡１２例；伤后感染或多脏器功能障碍死亡１７例。有２３３例为急诊观察治疗。急诊抢救成活率９２％。结论：强调此类伤病员必须由急诊科医师负责组织指挥，连续不断地采取以脑部伤为主的快速、准确、有效的综合措施和处理其他多发伤，其次要对急诊留观的伤员严密观察，并加强脑组织保护和营养支持，以及预防创伤性感染。

Objectives:To discuss the important significance and ways of the emergency treatment of cranial injury with multiple trauma. Methods:Seven hundred and twenty eight cases of cranial injury with multiple trauma were reviewed and analyzed. Results:Eighty percent of the cases were young adults,aged from 20 to 45.Fifty five cases died,in which 36 due to severe cranial injury complicated with obstinate shock.Twelve died of brain death,while seventeen died of posttraumatic infection or multiple organ dysfunction.Two hundred and thirty three cases were admitted and observed for days.The total survival rate was 92%. Conclusions:An emergency specialist is needed to organize and be responsible for the general treatment of such cases and continuously,rapidly,correctly and effectively treat the cranial injury,as well as other trauma.Careful observation is emphasized with cerebral tissue protection,nutritional support and traumatic infection.