特重型颅脑损伤的院前急救和院内处理

目的从创伤现场、院前急救、到院后的神经专科处理及康复等一系列连锁关系，探讨提高特重型颅脑损伤救冶的整体水平的方法。方法对我科自1993年1月至2004年6月救治的124例患者进行回顾性总结。按照颅脑损伤的临床与病理过程，将特重型颅脑损伤分为三期，实行分期的、有重点的连续性治疗。结果在本组124例患者中生存56例(生存率45．2％)。其中恢复良好19例(15．3％)，中残13例(10．5％)，重残24例(19．4％)；死亡68例(54．8％)。结论特重型颅脑损伤成功的救治必须各个环节并重，尤其是事发现场与院前急救十分关键，良好的专科治疗是救冶的根本；如能及时实行现场抢救及专科治疗，不但可挽救部分患者生命，且可改善预后、提高生存质量。

Prehospital care and emergency treatment of critical craniocerebral trauma

Objective To discuss how to improve the whole level of emergent treatment of critical craniocerebral trauma by analyzing a series of relationships of neurological treatment and rehabilitation in the period from place of injuries, prehospital care to emergency room treatment. Methods Data of the patients with craniocerebral trauma admitted into our hospital from January 1993 to June 2004 were analyzed retrospectively. According to the clinical and pathological course of craniocerebral trauma, critical craniocerebral trauma was treated continually by three stages. Results Of 124 patients with critical craniocerebral trauma, 56 survived (survival rate of 45.2%), 19 (15.3%) received better recovery, 13 (10.5%) moderate disability, 24 (19.4%) severe disability and 68 (54.8%) died. Conclusions For a successful treatment of critical craniocerebral trauma, the first aid at injury and prehospital care is pivotal and special treatment fundamental. Immediate prehospital care at injury and emergency room treatment are critical for life saving and prognosis improvement and living quality of the patients with critical craniocerebral trauma.