重型颅脑损伤中期并发症的防治(附248例报告)

目的探讨重型颅脑损伤中期严重并发症的预防及治疗方法.方法对248例重型颅脑损伤患者(GCS 3～8分),采用早期鼻饲预防消化道出血,监测血清渗透压,预防肾功能衰竭,早期气管切开预防肺部并发症,及用亚低温减轻脑继发性损伤等方法进行治疗.结果248例重型颅脑损伤患者中,消化道出血28例,肾功能衰竭6例,肺炎52例.此三种并发症发生率为34.6%,总死亡率为27.4%.结论积极预防及治疗重型颅脑损伤患者中期并发症,可降低其死亡率.

The prevention and treatment for complications of middle stage of severe cerebral injury

Objective To study the clinical application and effects of prevention and treatment for serious complications of middle stage severe brain injury. Methods 248 case of patients with severe brain injury were studied. 212 were male arid 36 were female with age ranged from 11 to 73. Following treatment regimens were apllied,including early nasogastric feeding to prevent digestive tract bleeding, monitoring of serum osmotic pressure to prevent renal failure, performing tracheotomy early to prevent pulmonary complications and mild hypothermia to alleviated succeeding cerebral injury. Results Among 248 cases of patients with severe cerebral injury, digestive tract bleeding was found in 28 cases, renal fail- ure in 6 cases and pneumonia in 52 cases. The morbidity of the above-mentioned complications was 34.6% and total mortality was 27.4%. Conclusions The mortality can be decreased by prevention and treating of middle stage complications in patients with severe cerebral injury.