摘要
目的对特重型颅脑创伤救治中有关原则和措施进行再探讨。方法对110例GCS5分以下患者进行研究。男78例，女32例；平均年龄47．6岁。车祸为主要伤因（55．45％）。头颅CT检查显示严重脑挫裂伤伴颅内血肿81例（73．64％），弥漫性轴索损伤21例（19.09％）。行开颅血肿清除、脑挫伤灶清除和／或去骨瓣减压93例，气管切开62例，术后行脱水、亚低温和激素治疗。结果生存53例，死亡57例（51．8％）。结论对特重型颅脑创伤要及时手术清除血肿和失活脑组织，辅以去骨瓣减压。术后要围绕防治脑水肿，采用脱水、亚低温和激素等综合治疗，能在一定程度上降低死亡率。
Obective To study the clinital principles and measures on treatment of the most severe head trauma. Methods One hundred and ten patients with the most severe head trauma,whose soore on GCS was less than 5 and the ages were from 5 to 78 years(mean 47. 6 years),were invoved in the study. There was exensive bsevere brain contusion and laceration in 81 (73. 64% ), and diffuse axonal injury in 21(19. 09% ) diagnosed with CT. Surgical evacuation of hermatomas and necroic brain tissue,and/or surgical decompression was done in 93 (84. 55% ). Tracheotomy was performed in 62. Postopertively, dehydration therapy, moderate hy pothermia and steroid were applied. Results Fifty-three cases survived (48. 2% ) and fifty-seven cases died (51. 8% ). Conclusion Surgical evacuation of the hematomas and the necrotic brain tissue, and/or surgical decompression are done in time for the patient with most severe the injury. Dehydration therapy, moderate hypothermia and steroids are used post-operatively. These measures can reduce the mortality.
出处
《创伤外科杂志》
1999年第3期132-134,共3页
Journal of Traumatic Surgery
