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摘要: 目的:探讨颅脑损伤合并全身其他部位外伤的临床救治方法。方法:回顾性分析我科2009-01-2012-08收治的84例以颅脑损伤为主的全身多发伤患者的临床资料和救治方法,总结救治经验。结果:以颅脑损伤为主的全身多发伤占据同一时期颅脑损伤患者的15.3%,合并伤中以胸部外伤和全身多发骨折最多。颅脑损伤处理最为棘手,ISS评分最高,按格拉斯哥结局量表GOS分级,经治疗和抢救后恢复良好27例(32.1%),轻度残疾21例(25.0%),重度残疾24例(28.5%),死亡12例(14.4%)例。死亡原因:8例因中枢性呼吸循环功能衰竭致死,2例因失血性休克,1例因严重的胸部外伤,1例因误吸致死。结论:颅脑损伤合并全身多发伤的患者多见于车祸伤。建立完善的急救体系和争取宝贵的救治时间是关键,入院后诊断明确和处理及时、正确是救治成功的前提,后期预防并发症的发生也是救治成功的重要方面。Abstract: Objective:To Explore the clinical treatments of patients of craniocerebral injuries combined with multiple trauma.Method:The clinical data of 84 craniocerebral injury patients combined with multiple trauma admitted to our hospital were retrospectively analyzed and summarized.Result:Head trauma with multiple injuries occupy 15.3% of patients with traumatic brain injury during the same period.Chest trauma and systemic multiple fractures are most common.Head trauma is the thorniest for management,and has the highest ISS.According to the Glasgow Outcome Scale GOS classification,27 cases have good recovery after treatment and rescue(32.1%),21cases(25.0%)have mild disability,24 cases(28.5%)have severe disability,and 12 cases(14.4%) died.Among the died cases,eight cases died of central respiratory and circulatory failure,2 patients died of hemorrhagic shock,1 patient died of severe chest trauma,and 1 patient due to aspiration.Conclusion:Traumatic brain injury combined with multiple trauma are common in traffic accident.Establishing first aid system and fighting for valuable treatment time is critical.Definitive diagnosis and timely treatment is prerequisite for successfully treatment.Prevention of the occurrence of late complications is also an important aspect for successful rescue.
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Key words:
- craniocerebral trauma /
- multiple trauma /
- management
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