陆路交通事故致重型颅脑损伤的救治  

THE TREATMENT OF SEVERE CRANIOCER-BRAL LNJURIES BY TRAFFIC ACCIDENTS

作　　者：周荣根[1] 张春[1] 

机构地区：[1]浙江省衢州市人民医院神经外科,324000

出　　处：《河北医学》1997年第4期8-10,共3页Hebei Medicine

摘　　要：目的：探讨交通事故及严重颅脑损伤的特征和救治，以求降低死亡率。方法：对1992年1月～1994年12月收治的39例严重颅脑交通事故伤的临床资料进行回顾性分析。结果：39例严重颅脑交通事故伤占同期严重颅脑伤的56％，其临床特征为：伤势严重紧急、意识障碍明显，有广泛性脑挫、裂伤及不同程度的脑肿胀、颅内血肿发生率高、有多发性颅骨骨折。开放性损伤有：脑组织外溢、伤口污染严重、合并伤多。结论：救治原则应注意院前急救。防止误吸导致自息。尽早转达专科医院抢救。对开放性损伤要早期彻底清创，以防感染。进行颅内压监护是有帮助的。积极治疗致命的合并伤，如有肝或脾等内脏破裂，应尽快剖腹探查，除病人因颅内血肿发生脑疝外，剖腹探查术常先于开颅术。Aim:It is reviewed how to explore Characteristics of severe head in-juries in traffic accidents and giving Salvage for reducing the mortality rate. Methods:The clinical data of 39 cases of those admitted to our hospital from Jan. 1992 toDec. 1994 Were analysed retrospectlvely. Results: The clinical characteristics of the39cases in 56% of all serere brain injuries in the same period,were sereious and emergehcywound, confueion and unconsciousness, broad brain contusion and laceration, confusionand unconsciousness, broad brain contusion and laceration, brain swelling of differentgrades,high incidence of intracranial hematoma, multiple fracture of the skull. severeopen head injuries were brain flowing over through the wound, wounds contaminatedweverely and complicated multiple systemic injuries Conclusion: The main principlesshould be stressed on pre-hospital emergency treatment preventing airway obstructedand transporting the patients to hospital with specialized neuro-surgery as soon as pos-sible,in oder to prevent inflammation wound cleansing treatment was to be early andwhole,monitoring intracranial pressure was helpful,treating the cases actively for fatalcomplication, if they nave rupture of the liver and spleen operative check-up open-ab-domen as soon as possible, unless the patients had brain herniation for intractanialhematoma the operative check - up open - abdomen should be earlier than operativetreatment for head.

关 键 词：交通事故 颅脑损伤 急救 治疗 

分 类 号：R651.150.5[医药卫生—外科学] U491.3[医药卫生—临床医学]