重型颅脑损伤临床诊治分析

【】　目的　探讨重型颅脑损伤的临床特点和救治经验。　方法　回顾性总结2002年1月-2008年12月所诊治重型颅脑损伤96例的临床资料。　结果　96例重型颅脑损伤患者，其中手术治疗59例，非手术治疗37例。按GOS评分，出院时恢复良好33例（34.4%），中残15例（15.6%），重残16例（16.7%），植物生存8例（8.3%），死亡24例（25.0%）。　结论　重型颅脑损伤仍然具有较高的病死率和致残率，早期及时手术清除颅内血肿解除脑疝，早期气管插管或气管切开并呼吸机支持治疗及其它积极恰当的综合治疗措施是抢救治疗成功的关键；后期加强护理注重防治并发症，可以最大可能挽救患者生命。？【Abstract】　Objective　Toexploretheclinicalcharacteristicsofseverecranio-cerebralinjuryanditstreatmentexperience.　Methods　Theclinicaldataof96patientswithseverecranio-cerebralinjuryfromJanuary2002toDecember2008wereretrospectivelyanalyzed.　Results　In96patientswithcranio-cerebral,59hadundergonethesurgeriesandtheothershadundergonetheconservativetreatment.AccordingtotheGlasgowoutcomescale(GOS),33(34.4%)hadagoodoutcome,15(15.6%)hadmoderatedisability,16(16.7%)hadseveredisability,8(8.3%)hadvegetativepersistentand24(25.0%)died.　Conclusion　Themortalityandmorbidityrateofthepatientswithseverecranio-cerebralinjuryarehigh,weshouldcleanouttheintracranialhematomaandrelievecerebralherniationintime,performedearlytrachealintubationortracheotomywithrespiratortherapy,andotheractiveandappropriategeneraltherapies,andavoidcomplicationsviarehabilitationtimeintensifynursingtorescuethepatients.