颅脑损伤；多发伤；损伤控制；交通事故_

交通事故致多发伤伴重型颅脑损伤的临床特点与救治

http://www.100md.com 《创伤外科杂志》 2006年第6期

颅脑损伤；多发伤；损伤控制；交通事故,,颅脑损伤；多发伤；损伤控制；交通事故,1病例选择标准,2一般资料,3诊治步骤及外科手术,1迅速甄别伤情，快

     摘要：目的探讨交通事故所致多发伤伴重型颅脑损伤的临床特点和救治策略。方法本组107例，GCS均<8分，均伴身体其他部位多处损伤，均需外科处理。行开颅手术清除血肿78例，去骨瓣减压71例，其他损伤均经外科治疗。在治疗中贯彻损伤控制外科(DCS)原则。结果存活59例(55.1%)，死亡48例(44.9%)。40例出院后6个月行GOS评分，显示恢复良好9例(22.5%)，中度残废16例(40%)，重度残废13例(32.5%)，植物生存2例(5%)。结论应用DCS原则处理多发伤伴重型颅脑伤有助于提高其生存率，对颅脑损伤的积极治疗是提高病人生存质量的重要环节。

    关键词：颅脑损伤；多发伤；损伤控制；交通事故

    Clinical features and managements of multipletraumas with severe head injury caused by traffical accidents

    LEI Peng,WANG Yu,TIAN Lizhuang,et al.

    (Department of Neurosurgery,Lanzhou General Hospital,Lanzhou 730050，China)

    Abstract : Objective To study the clinical features and managements strategy of multipletraumas with severe head injury caused by traffical accidents.Methods One hundred and seven cases of mutipletraumas was involved in the study,whose GCS score was <8.Evacuation of intracranial hematoma were performed in 78 cases(72.9%),and craniectomy for decompression in 71 cases.The Damage Control Surgery(DCS) principles was carried out during the therapeutic process.Results Fiftynine cases survived and 48 cases(44.8%) died.A followup of 6 months was taken after discharged in 40 cases,which reveale good recovery in 9 cases(22.5%),moderate disability in 16 cases(40%),severe disability in 13 cases(32.5%) and persistent vegetative state in 2 cases(5%).Conclusion It is important to carry out the principle of DCS,which contribute a lot to the survival rate. ......

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