高原地区(拉萨)颅脑交通伤的特点及救治分析

Characteristics and treatment of craniocerebral traffic injuries in plateau: Lasa

目的 探讨现代高原交通事故所致颅脑伤的特点及治疗措施。方法 回顾性分析本科近7年间收治的拉萨市交通事故所致颅脑伤656例。其中男性532例,女性124例;平均年龄32.6岁。本组轻型颅脑损伤123例,中型241例,重型292例。结果 汽车交通事故为本组病例颅脑损伤的主要交通事故原因,出租车为肇事高发车群。高发时间在7～9月份。本组手术治疗273例;非手术治疗383例。其中轻型颅脑损伤无一例重残或死亡;中型颅脑损伤重残42例,死亡12例,重残、死亡率为8.2％;重型颅脑损伤重残66例,死亡123例,重残、死亡率为28.8％。结论 (1)拉萨市出租车肇事是造成颅脑交通伤的重要原因,7～9月为高发时问;(2)高原低氧环境,常致颅脑损伤伤情加重,进展快,特点是伤情重,合并伤多,死亡及致残率高。尽早清除颅内血肿,去大骨瓣减压,亚低温治疗,维持内环境稳定及防治并发症等措施,可改善重型颅脑损伤的预后。

Objective To study the characteristics and treatment of modern craniocerebral traffic injuries in plateau. Methods The data of 656 cases with brain traffic accidents injuries treated in our hospital from 1996 to 2002 were retrospectively reviewed and analyzed. There were 123 cases with mild traumatic brain injuries, 241 medium and 292 severe. Results Taxi involving traffic accidents were the main victim-makers in this study, with the period of their highest occurrence from July to September each year. 273 cases were treated with surgery, and 383 cases with non-surgery. Among those with mild traumatic brain injuries there was no severe disability or death. Among those with the medium there were 42 cases with severe disability and 12 cases of death. Among those with severe injure there were 66 cases with severe disability and 123 cases of death. The total mortality was 20.6 %. Conclusion (1) Craniocerebral traffic injuries possess the characteristies of severe injuries and multi-injuries. Taxi involving traffic accidents are the causes in brain traffic accidents in Lasha. The period from July to September has a high occurrence. (2) As a result of low oxygen and terrible road conditions, it is difficult to treat the injuries immediately so that the mortality remains higher. The prognosis of most severe craniocerebral injuries can be improved by early intracranial removal with large decompressive cranietomies, early moderate hypothermia therapy and effective prevention and treatment of complications.