170例重型颅脑损伤的临床分析

Clinical analysis of 170 patients with severe craniocerebral injury

目的 总结重型颅脑损伤患者的救治方法及经验.方法 对我科收治的170例GCS评分3～8分的重型颅脑损伤患者的临床资料进行回顾性分析.结果 170例患者中标准外伤大骨瓣开颅术治疗135例,不需开颅手术17例,呼吸循环衰竭无法耐受手术治疗18例;按格拉斯哥预后评分法（GOS）评定：存活120例,随访6个月,恢复良好40例,中残20例,重残10例;死亡50例,其中术后死亡17例.结论 重型颅脑损伤患者病情危重、并发症多、病死率高,标准外伤大骨瓣开颅术可有效降低颅内压,解除脑疝,综合治疗可提高存活率.

Objective To summarize the treatment experience and methods for severe craniocerebral injury. Methods 170 cases of severe craniocerebral injury patients were retrospectively analyzed,whose Glasgow coma scale （GCS） grade between 3 to 8. Results In 170 cases,135 cases were treated by standard large trauma craniotomy,17 cases were treated by non-craniotomy, 18 cases were impossible to tolerance operation due to respiratory and circulatory failure. According to GOS grading system, 120 patients survived after 6 months, good recovery in 4, moderate disability in 20, severe disability in 10 and 50 died including 17 died after operation. Conclusions Patients with severe craniocerebral injury have severe illness, complications and high mortality rate. Standard large trauma craniotomy can effectively reduce the intracranial pressure and cure cerebral hernia, and can improve the survival rate with the comprehensive treatment.