特重型颅脑损伤68例临床救治效果观察

Observation of treatment effect of severe craniocerebral injury:on 68 cases report

目的观察特重型颅脑损伤的临床救治效果。方法特重型颅脑损伤患者68例,所有脑挫裂伤合并颅内血肿患者均急诊行开颅探查术、血肿清除加去骨瓣减压术,弥漫性脑肿胀者实施双侧去大骨瓣减压术。结果术后随访3～6个月,死亡33例(48.5%),植物生存9例(13.2%),重残12例(17.6%),中残6例(8.9%),良好8例(11.8%)。结论加强对特重型颅脑损伤患者伤情变化的观察,积极行手术减压及生命支持,维持有效的脑血流灌注和脑供氧,改善脑微循环,预防和控制并发症,是提高特重型颅脑损伤患者救治成功率和生存质量的重要手段。

Objective To analyze the clinical efficacy of severe craniocerebral injury. Methods 68 cases patients with severe craniocerebral injury, all cerebral contusion patients with intracranial hematoma were given emergency craniotomy exploratory surgery, hematoma plus decompressive craniectomy, patients with diffuse brain swelling implemented bilateral hemi-craniectomy. Results Patients were followed up for 3 to 6 months, 33 cases died （48. 5% ）, vegetative state 9 cases （ 13.2% ） ,severely disabled 12 cases （ 17.6% ） ,moderate disabled 6 cases （8.9%） ,good recovery 8 cases （ 11.8% ）. Con- clusion Strengthening observation on the condition of severe craniocerebral injury patients, actively implementing surgical de-compression and life support, maintaining effective cerebral blood flow and cerebral oxygen, improving cerebral microcireula-tion, and preventing and controlling complications are the major means of raising the success rate for treatment and life quality of patients with severe craniocerebral injury.