小儿重型颅脑损伤49例救治的临床体会

The clinical experience in treatment of 49 pediatric patients with severe head injury

目的总结小儿重型颅脑损伤的救治体会。方法回顾性分析49例小儿重型颅脑损伤患者的临床资料,对其救治过程和效果进行记录并且统计,出院时按GOS评分进行疗效判定。结果根据格拉斯预后评分(GOS)判定疗效:存活44例,经4至12个月随访,恢复良好25例,中残11例,重残8例,植物状态生存0例,死亡5例。结论小儿重型颅脑损伤的临床表现与损伤程度不一致,低血压发生率高,通过积极治疗,预后较成人好。

Objective To summarize the experience in treatment of pediatric patients with severe head injury.Methods The clinical data of 49 pediatric patients with severe head injury treated in this hospital were retrospectively reviewed and analyzed.The process of treatment and its effects were recorded,and their therapeutic efficacy was evaluated according to GOS scores at discharge.Results After the treatment,44 cases survived and 5 cases died.The results of follow-up for 4 months to 1 year indicated that 25 cases had got good recovery;11 cases with moderate disability,8 cases with severe disability and no one with persistent vegetative state（PVS） according to Glasgow outcome scale（GOS） scores.Conclusion The manifestations of severe head injury are inconsistent with the degree of injury in pediatric patients,while they are usually with high incidence of low blood pressure.But through active treatment,their prognosis is better than that of adults.