二次脑损伤因素对重型颅脑损伤手术效果的影响

目的 探讨重型颅脑损伤(severe craniocerebral injury,SCCI)术后二次脑损伤(secondary.braininjury,SBI)因素对手术效果及预后的影响.方法 采用回顾性研究的方法,对近年来的134例SCCI手术病例进行回顾分析,找出二次脑损伤因素与手术效果及预后的关系.结果 根据出院时GOS评定结果,良好72例(53.73％),中残15例(11.19％),重残13例(9.70％),植物生存9例(6.72％),死亡 25例(18.66％).结论 重型颅脑损伤术后,二次脑损伤因素的异常波动是导致SCCI患者二次脑损伤的重要因素,其中术后低血压休克、低血容量所致的脉率加快、伤后ICP异常升高以及术后高热等对手术效果影响巨大,严重影响预后.

Effect of secondary brain injury on surgical outcomes in patients with severe craniocerebral injury

ObJective To explore the effect of secondary brain injury on surgical efficacy and prognosis in patients with severe craniocerebral injury （ SCCI ）. Methods The clinical data on patJents who had undergone surgery for SCCI in recent years were retrospectively analyzed. The association of secondary brain injury with surgical efficacy and prognosis. Results According to the results of GOS assessment at discharge, 72 patients （ 53.73% ） were satisfied, 15 （ 11.19% ）were mild disable, 13 （ 9.70% ）were severe disable, 9 （ 6.72% ）were in vegetative state, and 25 （ 18.66% ） were dead. Conclusions Abnormal changes in factors of secondary craniocerebral injury result in severe craniocerebral injury. Postoperative hypotension-induced shock, rapid pulse caused by hypovolemia, abnormal elevation in ICP, and postoperative high fever have negative effects on surgical efficacy and prognosis.