术前双侧瞳孔散大颅脑损伤病人救治经验

目的总结24例术前伴有双侧瞳孔散大颅脑损伤病人的救治体会。方法对24例术前双侧瞳孔散大颅脑损伤病人的临床资料进行回顾性分析。结果 24例术前伴有双侧瞳孔散大颅脑损伤病人中死亡8例,存活16例,其中良好4例,中残4例,重残3例,植物生存5例。结论尽早气管插管,通过绿色通道尽早手术清除血肿、大骨瓣减压前预减压,术后尽早气管切开呼吸机辅助呼吸,维持内环境稳定,积极防治并发症等方法能提高救治双侧瞳孔散大颅脑损伤病人成功率。

Experiences in treating brain injury patients accompanied with preoperative dilated both pupils

Objective To summarize the experiences in treating 24 patients with preoperative brain injury accompanied with dilated both pupils. Methods The clinical data of 24 cases with preoperative brain injury accompanied with dilated both pupils were analyzed retrospectively. Results Of 24 patients with preoperative brain injury accompanied with dilated both pupils,8 died, 16 were survival,among them 4 were good, moderate disability in 4, severe disability in 3 and vegetative 5. Conclusions Eearly tracheal intubation,through green channel to operation to remove the hematoma, pre decompression before the large bone flap decompression, early postoperative tracheotomy ventilator assisted breathing, to maintain a stable internal environment, striving to prevent complications can improve the treatment success rate to the patients with preoperative brain injury accompanied with dilated both pupils.