重型颅脑损伤合并失血性休克的救治

目的探讨重型颅脑损伤合并失血性休克的早期诊断和治疗。方法回顾性分析68例颅脑损伤合并失血性休克病例的临床资料。结果恢复良好33．8％，中残11．8％，重残17．6％，植物生存状态8．8％；死亡19例，占27．9％。死亡原因：脑干呼吸循环功能衰竭7例，脑疝合并严重失血性休克4例，失血性休克后DIC3例，术后非中枢性呼吸衰竭2例，长期昏迷多脏器功能衰竭3例。结论颅脑损伤合并失血性休克损伤病情重笃复杂，及早明确诊断、及时明确损伤的主次部位、正确把握手术时机、合理治疗是成功救治的关键。

Remedy of severe head injury combined with hemorrhagic shock

Objective To investigate the early diagnosis and treatment of severe head injury combined with hemorrhagic shock. Method Sixty-eight cases of severe head injury combined with hemorrhagic shock were analyzed retrospectively. Results There were 33.8% of cases with good outcomes, 11.8% with moderate disability,17.6% with severe disability,8.8% with vegetative state, and 27.9%(19 cases) died. The cause of death:7 cases of functional failure of brain stem, 4 cases of brain hernia with hemorrhagic shock,3 cases of DIC,2 cases of respiratory failure,3 cases of MOSF. Conclusion The outcomes of the severe head injury combined with hemorrhagic shock should be improved if the early diagnosis and treatment strategies were succeed.