重型颅脑损伤伴休克患者的救治

Management of Severe Craniocerebral Injury Complicated by Shock

目的总结重型颅脑损伤并休克患者的救治经验,分析其休克发生的原因及机理。方法对我院1997年1月～2003年1月收治的68例重型颅脑损伤伴休克患者进行回顾性分析。对病人严密监护,及时进行手术,抗休克及其他综合治疗。结果本组68例病人31例存活,37例死亡,死亡率为54.41%。结论早期迅速查明休克原因,正确早期治疗尤为重要。绝不能把重度休克病人的意识障碍简单地归结于颅脑损伤,更不能把血压下降归结于高颅内压危象、继发性脑干损伤,而延误治疗。

Objectives To summurize the experience in treating of severe craniocerebral injury complicated by shock,and to analyse the causes and mechansim of the shock. Methods The clinical data of 68 patients with severe craniocerebral injury complicated by shock, who were admitted to our hospital from January 1997 to January 2003, were analysed retrospectively. Under the of careful monitoring in NICU, the relevant operation and treatment were performed in time. Results Of 68 patients with severe craniocerebral injury complicated by shock, 31 were cured and 37 died. The mortality was 54.41%(37/68). Conclusions It is very important to find early the causes of shock and to give proper treatment. The disturbance of consciousness in the patients with severe craniocerebral injury complicated by shock can not be simply attributed to craniocerebral injury. The shock may never be attributed to the crisis of increased intracranial pressure and secondary brain stem injury, otherwise the chance of treatment shall be missed.