重型颅脑伤120例死亡原因分析

Causes of 120 fatal traumatic brain injured patients

目的 分析造成颅脑损伤患者死亡原因。为提高颅脑损伤患者治疗效果提供依据。方法 对 12 0例重型颅脑损伤患者作回顾性调查分析。结果 12 0例中 ,车祸 (6 5 .83% )跌伤 (15 .83% )坠落 (10 .83% )是造成颅脑损伤的最常见原因。继发性脑水肿 (5 2 .5 % ) ,脑干功能衰竭 (2 8.3% ) ,肺部感染 (10 % )是导致死亡最主要的因素 ,其发生与患者年龄GCS评分、瞳孔变化、生命体征的稳定性、多发伤的存在及头部CT影像的变化有着密切的关系。结论 判断脑外伤预后及寻找行之有效的方法控制创伤后颅内高压 ,防治肺部感染及上消化道出血等并发症是降低颅脑伤患者死亡率的关键。

Objective\ To discuss the major causes of death in severe traumatic brain injured patients.Methods\ Retrospective data from 120 fatal tranmatic brain injured patients were analyzed.Results\ Motor vehicle accidents(65.83%),fall(15.83%)and height dropping(15.83%)were the most freguent causes of severe traumatic brain injury(TBI).The mortality of TBI patients resulted from uncontrolled high ICP of severe cerebral contusion(52.5%),brain stem injury(28.3%)and respiratoty complications(10%).Conclusion\ The control of high ICP as well as management of respiratory eomplications and upper gastrointestial bleeding are the most useful measures to reduce mortality of TBI patients.