海上颅脑损伤紧急救治与安全转运研究  

Emergency treatment and safe transport of maritime craniocerebral injury

作　　者：滕家杰 徐伟 杨建炳 魏梁锋 王守森 张灏 TENG Jiajie;XU Wei;YANG Jianbing;WEI Liangfeng;WANG Shousen;ZHANG Hao(Surgery Zone No.3,Lianjiang County General Hospital,Lianjiang,Fujian 350500,China;Department of Neurosurgery,Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuding,Fujian 355200,China;Department of Neurosurgery,Xiapu County Hospital,Xiapu,Fujian 355100,China;Department of Neurosurgery,Fu Zong Clinical Medical College(Hospital No.900),Fujian Medical University,Fuzhou,Fujian 350025,China)

机构地区：[1]福建省连江县总医院外科三区,福建连江350500 [2]福建中医药大学附属福鼎医院神经外科,福建福鼎355200 [3]福建省霞浦县医院神经外科,福建霞浦355100 [4]福建医科大学福总临床医学院(第九〇〇医院)神经外科,福建福州350025

出　　处：《中华神经外科疾病研究杂志》2024年第6期42-46,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：联勤医学重点专科(神经外科)项目(2022ZL01);福建省科技计划科技创新平台项目(2022Y2017)。

摘　　要：目的总结海上颅脑损伤的治疗结果,探讨海上颅脑损伤的有效治疗方法。方法回顾近年收治的海上颅脑损伤病例,总结转运技术和救治效果。结果3例患者均为男性渔民或游客,年龄分别为47、40及56岁,均被缆绳致颅脑损伤,远程转运至陆地医院救治,经清创或开颅手术,前2例恢复良好,伤后均无落水经历;第3例死亡,该例伤后即落水,合并海水淹溺伤。结论海上颅脑损伤后,如果落水,可使伤情更为严重和复杂。及时进行有效的初步处理和平稳的轮船转运,以及进行清创、预防感染和必要的外科干预,可以明显提高预后。Objective To summarize the clinical outcomes of traumatic brain injury sustained in maritime environments and investigate effective therapeutic strategies for managing such injuries.Methods A retrospective analysis was conducted on cases of maritime traumatic brain injury admitted in recent years,with a focus on the efficacy of transportation methods and overall treatment outcomes.Results Three cases involved male individuals,either fishermen or tourists,aged 47,40,and 56 respectively,who sustained traumatic brain injury due to roperelated accidents at sea and were evacuated for a long distance to land-based medical facilities for treatment.Following debridement or craniotomy,the first two patients demonstrated favorable recovery,and did not experience post-injury immersion.The third patient,who was immediately immersed and drowned in water following the injury,did not survive.Conclusions Immersion in water following maritime traumatic brain injury can significantly exacerbate the severity and complexity of the injuries.Prompt and effective initial management,combined with stable maritime transport,debridement,infection prophylaxis,and necessary surgical intervention,markedly improves clinical outcomes.

关 键 词：海上颅脑损伤 安全转运 抗感染 院前急救 海水相关性损伤 

分 类 号：R651[医药卫生—外科学]