特重型颅脑损伤的早期抢救及综合系统治疗

Early rescue and comprehensive systemic treatment for extra severe craniocerebral injury

目的探讨特重型颅脑损伤救治的方法与效果。方法回顾分析本组436例特重型颅脑损伤患者的早期抢救及综合系统治疗措施。结果本组436例患者，随访1个月～5年，手术治疗237例，保守治疗199例，生存者按日常生活能力量表（ADL）评定，良好191例，占43．8％；中残72例，占16．5％；重残40例，占9．2％；植物生存19例，占4．4％；死亡114例，占26．1％。结论根据特重型颅脑损伤患者的临床与病理变化过程，将其分为急性期、恢复期、康复期，依患者所处时期分别采取个性化综合系统治疗，可显著降低特重型颅脑损伤患者的病死率及伤残率。

Objective To investigate treatment method and effect for extra severe craniocerebral injury. Methods A retrospective analysis was made on early rescue and comprehensive systemic treatment measures for 436 extra severe eraniocerebral injury patients. Results All the 436 eases received follow-up for 1 month-5 years. There were 237 cases receiving surgical treatment, and 199 cases receiving conservative treatment. Activities of daily living （ADL） scale was applied in evaluation, and it showed 191 good eases, accounting for 43.8%, 72 moderately disabled cases, accounting for 16.5%, 40 severely disabled cases, accounting for 9.2%, 19 persistent vegetative state cases, accounting for 4.4%, and 114 death cases, accounting for 26.1%. Conclusion Extra severe eraniocerebral injury patients were divided by their clinical and pathological changes into acute stage, recovery stage, and convalescence stage. They received individualized comprehensive systemic treatment by their stages. This method can remarkably reduce mortality rate and disability rate in extra severe craniocerebral injury patients.