颅脑损伤致死伤员尸检报告的回顾性分析

Retrospective analysis of autopsy reports of the craniocerebral injury death

目的总结交通事故中单纯颅脑损伤致死伤员的伤情特征、损伤程度和最终死亡原因,为今后交通事故颅脑损伤伤员的急救处置和培训提供指导。方法收集四川省德阳市2009年1月至2012年8月交通事故中299例单纯颅脑损伤现场死亡或经院前急救、院内抢救无效死亡,并且经法医尸检的交通事故死亡伤员的尸检报告,分析死亡伤员的伤情特征、损伤程度和最终致死原因。结果 299例颅脑损伤死亡伤员中男性237例(占79.26%),女性62例(占20.74%);受伤类型为特重型和重型颅脑损伤,无中型和轻型颅脑损伤;201例(占67.22%)特重型颅脑损伤中72.64%现场死亡,98例(占32.78%)重型颅脑损伤无现场死亡伤员;闭合性颅脑损伤是特重型和重型颅脑损伤的主要类型。结论①尸检颅脑损伤死亡伤员为特重型或重型颅脑损伤,以特重型为主,72%以上的特重型颅脑损伤伤员现场死亡;闭合性损伤是两型颅脑损伤的主要类型;最终致死原因为三种或三种以上颅脑损伤同时存在的复合性颅脑损伤;男性占76%以上。②交通事故颅脑损伤伤员救治的重点是提高重型颅脑损伤伤员抢救的成功率和生存时间,降低重型颅脑损伤伤员的死亡率。

Objective~ To retrospectively analyze the injury characteristics, of damage and the ultimate cause of death of simple craniocerebral injury in traffic accidents in order to provide the guide for craniocerebral injury emergency treatment and training. Methods The forensic autopsy reports of 299 cases of simple craniocerebral injury scene death or rescue invalid death before or in hospitals from January 2009 to August 2012 in Deyang city were collected. The injury characteristics, extent of damage and ultimate cause of death were retrospectively analyzed. Results Of the 299 cases,237 cases were male （79. 26% ） and 62 cases were female （20. 74% ）. The types of injury were the most severe or severe craniocerebral injury,and there was no medium or mild traumatic brain injury. Of the 299 cases , 201cases （67.72%） suffered from the most severe craniocerebral injury,in which 72. 64% were the scene death,and 98 cases （32.78%） were severe craniocerebral injury but no scene death. The closed craniocerebral injury was the major type of the most severe and severe cranidcerebral injury. Conclusion ① The deaths were the most severe or severe, mainly the most severe craniocerebral injury. More than 72% of patients with the most severe craniocerebral injury died on the scene. The closed injuries are the two main types of craniocerebral injury. The ultimate causes of death are three or more kinds of cranial brain injury at the same time. Male cases account for more than 76%. ② The key to rescue the wounded head injury in traffic accidents is to improve the suc- cessful rescue rate and survival time of the severe craniocerebral injury, thereby reduce the mortality.