儿童重型颅脑损伤相关因素研究

目的探讨分析影响儿童重型颅脑外伤诊治的相关因素。方法选择我院2008年2月—2011年2月收治的3～12岁儿童重型颅脑损伤38例,全部于入院前行颅脑CT检查确诊,其中3～7岁25例,7～12岁13例。GCS评分3～5分15例(特重型),6～8分23例(重型)。车祸伤16例,坠落伤13例,其他伤9例;住院时间最长8～112d,平均26d。结果按格拉斯哥预后评分(GOS):良好19例,轻残11例,重残2例,植物生存1例,死亡5例,重度残疾及病死率为21.05%,死亡率为13.15%。结论儿童神经系统处于发育阶段,尚未成熟,在重型颅脑损伤时,只要及时诊断与治疗,其疗效常优于成人。若能早期积极预防各种继发性损害,进行肢体功能、语言康复训练,能显著减少患儿的病死率和致残率,提高生存质量。

Clinical Study on the Relevant Factors of Severe Craniocerebral Trauma in Children

Objective To discuss the relevant factors for the diagnosis and treatment of severe craniocerebral trauma in children.Methods 38 children who aged from 3~12 during Feb.2008 to Feb.2011 were performed cranial CT.25 cases are aged between 3~7,and 13 are between 7~12.GCS scores:15 cases are 3~5(very serious),and 23 cases are 6~8(serious).16 cases injured from traffic accident,and 13 injured from falling.The hospitalization time were 8~112 days,with the average of 26 days.Results GOS:19 were good,11 with mild disability,2 with severe disability,1 was in vegetative status,and 5 cases died.The rate of severe disability and fatality was 21.05%,and the mortality rate was 13.15%.Conclusion The nervous system of children is in developmental stages.Timely diagnosis and treatment of severe craniocerebral trauma can achieve better effect than adults.The active prevention of secondary damage in early stage and rehabilitation training of limb function and language can obviously decrease the mortality and disability rate and thus can improve the quality of life.