提高基层医院重型颅脑损伤救治率探讨

目的 讨论如何提高基层医院重型颅脑损伤的救治率。 方法 回顾性总结分析我科1996年1月～2000年6月收治的192例重型和特重型颅脑损伤病人的救治情况。结果 按格拉斯哥结果分级法 ,Ⅰ级 (死亡 )45例 ,占23.44 % ;Ⅱ级 (植物生存 )6例 ,占3.13% ;Ⅲ级 (重残 ,生活部分自理 )21例 ,占10.94 % ;Ⅳ (中残 ,生活能自理 )39例 ,占20.31 % ;Ⅴ级 (良好 ,恢复工作学习 )81例 ,占42.19 %。 结论院前正确处理 ,急症室及时诊断、急救 (抢救插管、保持呼吸道通畅、防止低氧血症、纠正休克等 ) ,积极术前准备,及时手术清除血肿 ,呼吸机辅助呼吸 ,早期应用亚低温等治疗可提高救治率降低死亡率。

Objective To explore the methods that may improve the success rate of emergency treatment for patients with severe head injury in basic Hospital. Methods 192 patients with severe or specially severe head injury were treated in our hospital from Jannary 1996 to June 2000. Their clinical data were retrospectively analyzed. Results According to Glasgow Coma Scale (GCS), 45 patients(23.44%) belonged to grade Ⅰ(death), 6 (3.13%) grade Ⅱ(vegetative state), 21(10.94%) grade Ⅲ(serious disability); 39(20.31%) grade Ⅳ(moderate disability),81(42.19%) grade Ⅴ(recovery). Conclusions It may improve the salvage rate or decrease death rate to apply following methods, such as proper disposal before hospitalization, prompt diagnosis and emergency treatment, active preoperative preparation, promptly clearing hematom, assisted respiration with breathing machine, early usage of sub-hypothermia and so on.