颅脑损伤合并伤的诊治体会

The experience of diagnosis and treatment for head injury with other injuries

目的 探讨基层医院对颅脑损伤合并伤的救治。方法 本院收治８５例颅脑损伤合并伤，入院时ＧＣＳＳ≤９分，颅脑手术治疗５０例，去骨瓣减压血肿清除术３３例，钻孔血肿清除术９例，颞肌下减压术５例，微创血肿清除术３例。其它治疗包括气管切开、胸腔闭式引流、骨折切开复位内固定术、椎管减压、剖腹探查等。结果 死亡１８例，存活６７例（平均随访２年），其中重残１２例，轻残１８例，３７例恢复满意。结论 对颅脑损伤合并伤的救治，各科应通力合作，重点诊治危及生命的损伤，最大程度地降低死亡率及伤残率。

Objective To study the therapeutics for head injuries with other injuries in junior hospitals. Methods All the 85 cases showed no more than 9 scores on GCS, and 50 cases of them had head operations. Other therapies include: tracheotomies, closed-drainage of chest cavity, open reduction and internal fixation of fracture. spinal canal decompression, exploration of laparotion and so Results Death occurred in 18 cases (average follow-up two years) , severe disability in 12,moderate disability in 18 and Satisfactory recovery in 37. Conclusion To reduce the rate of death and disability, the emphasis on the therapeutics of head injuries with other injuries are the diagnosis and treatment of fatal wounds and the cooperation of concerned departments.