摘要
目的:回顾近4年来道路交通事故所致颅脑损伤、合并伤580例临床处理的经验.方法:将道路交通事故伤者按伤情分Ⅰ型、Ⅱ型、Ⅲ型和Ⅳ型,探讨受伤机理与救治原则等应用于临床。结果:按GOS结果评定,死亡94例,死亡率16.2％,植物生存占6％,重残占10％,中残占15％,良好占52.8％:各型死亡率:Ⅰ型13.77％,Ⅱ型6.38％,Ⅲ型51.69％,Ⅳ型1.35％;创伤多系高能量撞击伤,致伤机理复杂;并发多器官功能障碍(MODS)36例,其中死亡19例,占死亡总数的20.21％.结论:道路交通事故伤不仅是医学问题,又是社会问题,必须综合治理;加强安全意识教育和驾驶技能训练是降低事故发生的基本措施;及时有效的缓解颅内高压、恢复脑干功能、合理处置合并伤等是治疗的首要问题;并发症(如肺部感染等)的合理治疗是控制MODS的重要环节;综合救治是降低致残率、死亡率的关键手段,对临床治疗具有重要意义.
Objective: 580 cases of brain injury and its accompanied diseases resulted from road traffic accidents happened in the last 4 years were retrospectively studied. Methods: Victims in those road traffic accidents are grouped into Ⅰ, Ⅱ, Ⅲ and Ⅳ type in terms of severity, and mechanisms of injury and therapeutic guideline were discussed with the consideration of sequential clinical application. Results: By GOS we Diagnosed 94 cases died, mortality rate 16.2%, and in total population, it was constituted by 6% plantation living, and 10% the most seriously handicapped, and 15%medianly handicapped, and 52.8% good cases. In those dead cases, they included 13.77% type Ⅰ, Type Ⅱ2 6.38%, type Ⅲ 51.69%, and 1.35% type Ⅳ It was very complicated in the mechanisms for the traumatic-mutiple-high energetic-collision injuries. In 36 MODS cases 19 cases died 20.21% of the total dead cases. Conclusion: Injuries caused by road traffic accidents were not only a medical issue, but also a social problem Therefore, comprehensive measures should be taken. Safe driving education and driving skill training were two fundamental measures to lower the traffic accident rate. The primary issue in therapy should be to effectively alleviate the intracranial pressure, to restore the brain stem function and to properly deal with the accompanied diseases An important link in the treatment of MODS was that complications, such as pulmonary infections should be properly controlled. It was very useful to mention that comprehensive therapeutic guideline should be insisted considering its crucial role in reducing the handicap rate and mortality rate.
出处
《伤残医学杂志》
2004年第3期19-22,共4页
Medical Journal of Trauma and Disability
