耳鼻喉颌面伤合并颅脑损伤500例

目的 明确耳鼻喉颌面伤合并颅脑损伤患者群体的性别差异、年龄分布、主要致伤原因，探讨二者伤情之间的关系，统计颅脑损伤情况与伤情判断、治疗的方法和效果。方法 总结1265例耳鼻喉颌面损伤合并有颅脑损伤患者500例(39.60%)的病历资料，回顾性分析并加以统计学研究。结果 1265例中耳鼻喉颌面损伤部位在鼻听线平面及以上者388例(30.67%)，损伤部位在鼻听线平面以下者112例(8.85%)，鼻听线上下两部位损伤合并颅脑损伤发生率差异有统计学意义(P<0.01)；耳鼻喉颌面伤合并颅脑损伤500例中，男女比例4.1∶1；高峰年龄为20～49岁间计392例(78.40%)；交通事故居致伤原因首位239例(47.80%)；脑震荡、脑挫裂伤、颅内血肿分别占59.40%、11.80%、6.20%；按GCS伤情评分，轻型88.40%；按GOS预后评分，良好95.4%。结论 耳鼻喉颌面损伤合并颅脑损伤是现代创伤中常见复合伤，男性多于女性，发病患者群以青壮年为主，交通事故为致病主要原因，鼻听线对诊断有参考价值，患者损伤程度比较轻，只要及时诊断，正确救治，治疗效果好，致残率、死亡率低。

Cranio-maxillofacial trauma (500 cases report)

Objective To investigate the demographic, causes and clinical characteristics of cranio-maxillofacial trauma (CMT) to determine the appropriate treatment. Methods Among 1265 cases of ENT and/or maxillofacial injury, clinical data of 500 patients accompanied with brain injury were reviewed. Results In 1256 cases, injuries located at or above the nasal-acoustic line in 388 cases(30.67%) but under the plane in 112 (8.85%). The incidence of brain injury was significantly associated with this plane(P<0.01). In 500 CMT cases, the male to female ratio was 4.1 to 1, with the common ages ranging from 20 to 49. The leading cause of trauma was traffic accident(47.80%). As for brain injury, there were 59.40% concussion, 11.80% brain contusion, and 6.20% intracranial hematoma. According to GCS scoring system, 88.40% belonged to mild injuries and according to GOS prognostic score, and 95.4% recovered well. Conclusion Male is prone to CMT than females, esp. for young adults. The main reason is traffic accident. The nasal-acoustic line is helpful for the diagnosis. With correct and effective treatment, the death toll will be minimal.