重型颅脑损伤临床救治体会(附662例报道)  

Clinical treatment experience of the severe traumatic brain injury:report of 662 cases

作　　者：王洪生[1] 孟文博[1] 王鹏[1] 程月飞[1] 王志明[1] 赵佩林[1] 殷尚炯[1] 

机构地区：[1]解放军第二五一医院神经外科,张家口075000

出　　处：《中华神经创伤外科电子杂志》2017年第2期68-71,共4页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

摘　　要：目的总结重型颅脑损伤(sTBI)患者的临床救治经验,以提高治愈率、降低死亡率。方法回顾性分析总结解放军第二五一医院自2011年1月至2016年6月收治的662例GCS 3~8分颅脑损伤患者的临床资料。采取系统规范的救治措施,包括开通绿色通道、建立救治团队、强调团队配合,维持生命体征、快速开颅减压、妥善处理合并伤、积极预防并发症等。根据出院时GOS评定治疗结果。结果 662例sTBI患者,恢复良好:376例(56.8%),中残:83例(12.5%),重残:53例(8.0%),植物生存:8例(1.2%),死亡:142例(21.5%)。结论早期诊断、迅速解除脑受压、妥善处理合并伤、积极预防并发症、重视营养支持及康复治疗是改善sTBI患者预后的重要措施,规范创伤救治体系、多学科良好的协作是早期维持患者生命体征、迅速解除脑受压的保证。Objective To summarize the clinical treatment experience of 662 cases of severe traumatic brain injury（sTBI）,the aim of this study is to increase cure rate and deduce mortality rate.Methods Six hundred and sixty-two cases with GCS of 3 to 8 who were admitted to our hospital from January 2011 to June 2016 were analyzed retrospectively. The systematic and regulatory clinical treatment measures were adoped. The clinical treatment measures included open green channel,build crue team,strengthen cooperate of the team,maintain vital signs,craniotomy decompression fleetly,carefull and shillful handled the associated injury and prevented complication actively,etc. Results Among the 662 cases of sTBI 376（56.8%） cases were good recovery,83 cases（12.5%） were moderate disability,53 cases（8.0%） were severe disability,8 cases（1.2%） were vegetative state,142 cases（21.5%） were death. Conclusion Early diagnosis and quickly remove the compression of the brain,properly treat the combined wound and positive prevention the complication and pay attention to nutrition and treatment of convalescence were important to achieve good recovery of sTBI patients.Standardize the system of management of head injury and good cooperation of more departments were the pledge for early keeping the life singe of patients and remove the compression of the brain.

关 键 词：重型颅脑损伤 规范化治疗 预后 

分 类 号：R651.15[医药卫生—外科学]