重症颅脑损伤的急诊救治分析

Emergency treatment of patients with severe traumatic brain injury

目的总结重症颅脑损伤的救治经验。方法将我院自2011年2月—2012年1月救治的47例重症颅脑损伤患者按治疗方法分为观察组和对照组,其中观察组24例,对照组23例,且两组患者在性别、年龄、致伤原因以及格拉斯哥昏迷(GCS)评分等方面均无统计学差异(P>0.05)。观察组24例患者积极进行手术治疗,对照组23例患者行非手术治疗。结果观察组24例患者经过院前积极的抢救和院内及时的手术治疗,优良率为50.00%;而对照组23例患者中,优良率为21.74%。两组间优良率比较,差异有统计学意义(χ2=4.062 9,P<0.05)。结论重症颅脑损伤一般情况非常危急,在临床治疗过程中,急诊手术治疗的效果显著优于非手术治疗,因此对于重症颅脑损伤患者不但要进行积极的院外抢救,入院后要及时进行手术治疗,以提高患者的治疗效果。采用院外急救和院内手术治疗相结合的方法对挽救重症颅脑损伤患者的生命具有非常重要的意义。

Objective To investigate the experience in the treatment of severe traumatic brain injury （TBI）. Methods A total of 47 patients with severe TBI admitted to our hospital from February 2011 to January 2012 were divided trial group （ n = 24 ） and con- trol group （n = 23）. There were no significant differences in terms of gender, age, cause and Glasgrow coma score （GCS） between the two groups. The trial group was treated with active surgical operation, while the control group was treated conservatively. Results After a positive pre-hospital rescue and a timely nosocomial surgical treatment, the excellent rate of the trial group was 50.00% , significantly higher than that （21.74%） of the control group （ X2 = 4. 062 9, P 〈 0.05 ）. Conclusion In addition to active pre- hospital rescue, the clinical effect of emergency surgery on patients with severe TBI is significantly superior to that of conservative treatment.