432例颅脑交通伤临床分析  

Clinical Study on 432 Cases of Head Injury Caused by Traffic Accidents

作　　者：程晓斌[1] 简华刚[1] 付祥林[1] 林水金[1] 姚元章[1] 

机构地区：[1]第三军医大学附属大坪医院,野战外科研究所创伤科重庆400042

出　　处：《中华创伤杂志》1999年第2期110-112,共3页Chinese Journal of Trauma

摘　　要：目的研究交通事故致颅脑伤的临床特点及其对伤情结局的影响。方法对４３２例交通事故致颅脑伤患者按头伤伤情及结局分组，采用第三军医大学野战外科研究所研制的计算机创伤评分软件进行伤情评估，并计算生存概率（Ｐｓ）。结果４３２例中生存组３９９例，死亡组３３例，死亡率７６４％。两组年龄比较无显著性差异（Ｐ＞０．０５）。死亡组ＧＣＳ和ＲＴＳ分值较低，头ＡＩＳ和ＩＳＳ分值较高。两组Ｐｓ比较有显著性差异（Ｐ＜０．０１）。其中头胸双重型患者２４例，死亡４例，死亡率为１６．６％，明显高于头伤为主型患者（９．８０％）。结论交通事故致颅脑伤伤情复杂，其中脑挫裂伤、颅底骨折、原发性脑干伤、多发性颅内血肿及脑内血肿发生率较高，是车祸致死的主要原因，而合并伤中对患者伤情及结局影响最大的为严重胸部伤。Objective To study the clinical feature and morbidity of the patients withhead injury caused by traffic accidents as well as its effects on the situation and prognosis ofthe pan6nts. Methods A total of 432 patientS with head injury caused by traffic accidents wereevaluated with the trauma score software develops by the Research Institute of Surgery of theThird Military Medical University and grouped by trauma situation and the prognosis.Survival possibilities (Ps) among the groups were also predicated. Results There were 399 casesin the survival group, 33 cases in the death group, with the motality of about 7.64%. Thephysiological scoring (GCS and RTS) in the death group was lower, and AIS and ISS of thehead were higher than that of the survival group.Ps was statistically significantly differentbetween the two groups (P<0.01). Among 432 patients, 24 cases had severe head injurycombined with cheSt saury, 4 caac died, with the mortality of 16.66%, which was higher thanthat of the patients Only with head injury. Conclusions Head saury cause by traffic accidedis complex. The incidence of multiple intracranial hematoma, contusion and laceration of thebrain, primary wiury of the brain stem, and bade cramal fracture is higher,which is the maindeath cause of the patients with traffic trauma. Meanwhile, the incidence of complicated injur is higher, too. Severe chest injury has marked effaccts on the trauma situation and prognosis of.the patients.

关 键 词：交通事故 交通伤 颅脑损伤 临床分析 

分 类 号：R651.15[医药卫生—外科学]