66例特重型颅脑伤患者救治体会

目的 总结特重型颅脑伤(GCS3～5分)的救治经验。方法 对收治的66例特重型颅脑伤病例资料进行回顾性分析。结果 66例特重型颅脑伤者存活39例(59．1％)，其中恢复良好和中残25例(37．9％)，重残和植物生存14例(21．2％)，死亡27例(40．9％)。结论 采取综合疗法，注意保持生命体征稳定，尽早手术解除脑受压，早期亚低温治疗，加强手术前后的监护，维持内环境稳定及防治并发症等措施，可显著改善特重型颅脑伤患者的预后。

Clinical experience of management for the most severe head-injured patients (a report of 66 cases)

Objective To summarize the therapeutic experience of 66 patients with traumatic head injuries. Methods Sixty-six most severe head injured patients who admitted to our department from March 2001 to Feb. 2003 were analyzed retrospectively. Results Thirty-nine cases ( 59.1%) survived. Among them, 25 cases ( 37.9%) had a good recovery or moderate disability, and the remaining 14 cases were subjected to severe deficits or persistent vegetative state ( 21.2%). Twenty-seven cases were dead ( 40.9%) after therapy. Conclusion The prognosis of most severe head injured patients could be improved by comprehensive therapy including keeping the life sign stable, early operation to relieve intracranial pressure, early moderate hypothermia therapy, intensive care before and after operation, effective prevention and treatment of complications.