严重胸部损伤合并颅脑损伤的临床特点和救治策略

目的探讨严重胸部并颅脑损伤的临床特点及救治体会。方法对1995年1月至2005年1月我院收治的145例严重胸部损伤并颅脑损伤的临床资料进行回顾性分析。结果临床特点为伤势严重、呼吸困难、循环紊乱、低氧血症、休克、意识障碍、死亡率高等。总死亡率17.2%(25/145),死亡主要原因早期为严重失血性休克11例(45.8%)和严重颅脑损伤8例(33.3%),后期为呼吸窘迫综合征(ARDS)和多器官功能衰竭(MSOF)等6例(25%)。结论救治原则应强调争分夺秒,恢复呼吸循环稳定,降低颅内压,及早手术治疗,积极防治并发症。提高救治水平有助于降低死亡率和病残率。

Clinical Characteristics and Diagnosis-Treatment of Serious Thoracic Trauma Associated with Cerebral Trauma

Objective To explore the clinical characteristics and diagnosis-treatment of serious thoracic trauma associated with cerebral lesion.Methods Btween Jan 1995 and Jan 2005, 145 cases of serious thoracic trauma associated with cerebral injury were retrospectively studied. Results Clinical characteristics of all cases were seriously injured. dyspnea, circle disorders, hypoxemia, shock, and awareness disorders. The mortality was 17.2%(25/145).The early major causes of trauma death was exsanguinations (11cases,45.8%)and brain injury(8 cases,33.3%), the complications including adult respiratory depress syndrome(ARDS) and multiple organ failure(MSOF) were the lately main cause of the death(6 cases,25%). Conclusion It should be emphasized to treat as fast as possible including recover respiratory ,circle disorders, decreasing intracranial pressure, early operation, and positively treat complications.The mortality and the deformity rate can be reduced by use of these successful measures.