重型颅脑损伤合并伤的救治策略与预后分析

目的探讨重型颅脑损伤合并伤的救治策略与预后的影响因素。方法对480例重型颅脑损伤合并伤的死亡率进行统计学单因素χ2分析和多因素Logistic回归分析。结果重型颅脑损伤合并颈椎损伤、胸部损伤、多发合并伤、休克明显增加其死亡率。结论合并颈椎损伤、胸部损伤、多发合并伤、休克是影响重型颅脑损伤预后的重要因素,仔细迅速的体检,必要的影像学检查,颈椎损伤及早颈部制动防止二次损伤,积极抗休克治疗,尽早手术控制胸腹腔内出血,合理的救治顺序是降低重型颅脑损伤合并伤患者死亡率的关键。

Analysis of progrosis factors and management of complicated injuries in the patients with severe brain trauma

Objective To investigate the prognosis factors for the treatment of complicated injuries in the patients with severe brain trauma.Method Prospective study was carried out in 480 patients with complicated injuries of severe brain trauma.9 Factors were surveyed and analyzed by One-way ANOVY and multiple logistic regression.Results Severe brain trauma combined with cervical vertebral injury,thoracic injury,shock,multiple complicated injuries increased the mortality rate significantly.Conclusions Cervical vertebral injury,thoracic injury,shock,multiple complicated injuries are prognosis factors associated with severe brain trauma.Keys to decrease the death rate of complicated injuries in the patients with severe brain trauma are cervical brake,anti-shock treatment,controlling the hemorrhage in the thoracic and abdominal cavity earlier and reasonable sequence of treatment.