重型及特重型颅脑损伤救治100例的临床分析

Study on surgical treatment in 100 cases of heavy and severe craniocerebral injury

目的总结重型及特重型颅脑损伤救治经验,探讨有效的治疗措施和方法。方法对2007年2月至2011年10月间重型及特重型颅脑损伤住院患者100例的临床数据进行回顾性分析总结。结果恢复良好14例(14.00%),中度残疾13例(13.00%),重度残疾18例(18.00%),植物生存18例(18.00%),抢救成功率为63.00%。另外,死亡37例(37.00%),其中入院48 h内死亡24例,7 d后死亡4例。结论重型及特重型颅脑损伤的早期诊断及救治至关重要。我们应准确、及时地观察原发病,制定救治策略,积极防治感染,保持气道通畅,改善微循环,合理地应用减压措施,从而降低病死率。

Objective To summarize the experience and curative effect in surgical treatment of patients with heavy and severe craniocerebral in- jury and to explore the effective way for improving result of surgical treatment. Methods The clinical data of 1130 patients with heavy and severe cranioce- rebral injury during June 2009 to February 2011 were retrospectively analyzed. Results In these 100 cases, the rate of successful rescue was 63.00%, including good recovery in 14 cases （14.00%）,moderate disability in 13 cases （13.00%）, severe disability in 18 cases （18.00%）, vegetative status in 18 cases （ 18.00% ） and death in 37 cases （37.00%）. Twenty four cases died within 48 hours of admission, and 4 patients died after 7 days. Conclusion The early diagnosis and prompt treatment are very important in management of patients with heavy and severe craniocerebral injury. It is important to take accurate, timely observation on primary disease, and making plan of strategy to prevent and control infection, maintain airway patency, ameliorate microcircvlation and apply reasonable decompression measures in order to reduce the mortality.