小儿重型颅脑损伤的救治

目的 总结小儿重型颅脑损伤的临床特征与救治经验。方法 对1999年1月～2004年1月收治的45例重型颅脑损伤惠儿的发病特点、临床表现、CT检查特征、治疗方法等进行探讨，其中35例早期手术治疗，其余病例采取保守综合治疗。结果 该组45例存活42例（93．33％，42／45），死亡3例（6．67％，3／45）。40例（95．24％，40／42）患儿获随访（时间为6～66个月），28例（70．00％，27／4b）恢复良好，轻残7例（17．50％，7／40），中残3例（7．50％，3／40），重残2例（5．00％，2／40）。结论 小儿重型颅脑损伤发病急、病情重、变化快，应严密观察病情变化，早期诊断、及时抢救并配合积极的综合治疗措施能明显地改善预后。

Treatment of severe traumatic brain injury in children

Objective To explore retrospectively the clinical characteristics and treatment of severe traumatic brain injury in children. Methods Forty five children had suffered from severe traumatic brain injury between January 1999 and January 2004. We analyzed the characteristics of the occurrence, clinical manifestation and CT examination in severe traumatic brain injury. 35 out of the 45 cases were dealt with early surgery after trauma, and the others were managed by conservative comprehensive measurement. Results Of the 45 children with severe traumatic brain injury, 42 (93.33%, 42/45) cases had been survived and 3 (6.67%, 3/45) cases died. 40(95.24%, 40/42) cases in the 42 children survived had been followed up (ranged from 6 months to 5.5 years), 28 cases (70.00%, 27/40) were good, 7 cases (17.50%, 7/40) disabled mildly, 3 (7.50%, 3/40) disabled moderately and 2 (5.00%, 2/40) disabled severely. Conclusions It is essential in order to improve satisfactorily the outcomes of the treatment of the children with severe traumatic brain injury that the serious observation and proper diagnosis and timely treatment are made as early as possible due to the acute occurrence, severe trauma and rapid changing in children's severe traumatic brain injury.