特重型及重型颅脑损伤1049例分析

目的：总结1049例GCS 3～8分特重型及重型颅脑损伤病人的救治经验．方法：对通辽市科尔沁区第一人民医院脑外科1995—11～2003—10收治的GCS 3～8分特重型及重型颅脑损伤病人进行回顾性总结．结果：1049例GCS 3～8分特重型、重型颅脑损伤中治愈及好转714例(68．1％)，重残95例(5．6％)，死亡276例(26．3％)．在常规治疗方法基础上，430例病人加用尼莫地平和130例加用亚低温冬眠疗法治疗后，临床效果显著提高，治愈及好转444例(79．3％)，重残10例(1．8％)，死亡106例(18．9％)．结论：尽早清除颅内血肿，去骨瓣减压，早期亚低温治疗，呼吸机辅助呼吸，维持内环境稳定，防治并发症发生等措施，可显著改善GCS 3～8分特重型、重型颅脑损伤病人的预后．

Cured 1049 Cases of Severe Head Injury

Objective:To summarize the therapeutic experience of 1049 patients of traumatic head injured with a GCS score of 3 to 8. Methods:1049 most severe and severe head injured patients with a GCS score of 3 to 8 who admitted to our department rom Nov.1995 to Oct.2003 were analyzed retrospectively. Results:714 cases (68.1%) were recovered or improved, 95 cases with severe deficits,276 (26.3%) cases were dead after therapy. On the basis of routine treatment, 430 cases were treated with Nimodipine and 130 cases were treated with mild hypothermia in addition. The effect was obviously improved. Among them 444 cases (79.3%) were recovered or improved. 10 cases with severe deficits and 106 cases (18.9%) died.Conclusion:The prognosis of most severe and severe head injured patients with a GCS score of 3 to 8 could be improved by early evacuation of intracranial hematoma with large decompressive cranietomies, early moderate hypothermia therapy, early assistant ventilation and effective prevention and treatment of comolication.