交通事故致特重型颅脑损伤患者的救治分析(论文资料).docVIP

交通事故致特重型颅脑损伤患者的救治分析 作者：王树超，陈铮立，刘雪松，李建荣，李晨昊，叶世泰，施建国 作者单位：(解放军第117医院神经外科，浙江 杭州 310004) 　　【摘要】 目的 探讨交通事故致特重型颅脑损伤(GCS 3～5分)患者的伤情特点及提高救治水平的方法。方法 对我院自2001年6月～2008年5月采用综合治疗的资料完整的76例由交通事故导致的特重型颅脑损伤患者进行分析，其中高速公路组24例，普通公路组52例，并对高速公路和普通公路发生的特重型颅脑损伤患者进行对比分析。结果 高速公路组24例，死亡12例，死亡率为50%;生存者按格拉斯哥预后评分(GOS),恢复良好3例(12.5%),中残2例(8.3%),重残4例(16.7%),植物生存3例(12.5%)。普通公路组52例，死亡39例，死亡率为75%;恢复良好6例(11.6%),中残4例(7.7%),重残2例(3.8%),植物生存1例(1.9%)。结论 高速公路伤员多为男性青壮年，送院时间较长，多发伤比例高，休克发生率高，GCS评分3分患者极难生存。但只要积极救治，高速公路伤员也可以取得与普通公路相似的疗效。 　　【关键词】 颅脑损伤;道路交通伤;急救 　　AAnalysis of treatment for the extrasevere traumatic brain injury caused 　　by traffic accident 　　WANG Shuchao,CHEN Zhengli,LIU Xuesong,et al. 　　(Department of Nurosurgery,117th Hospital of PLA,Hangzhou 310004,China) 　　Abstract： Objective To discuss the characteristics of extrasevere traumatic brain injury(TBI) caused by traffic accident and enhance the treatment level.Methods Totally 76 cases of extrasevere TBI caused by traffic accident admitted in our hospital from Jun.2001 to May.2008 were analyzed,including 24 cases occurred on highway and 52 cases on common road,and the outcome was compared between these two groups.Results The mortality rate of the highway group was 50%(12/24).According to the Glasgow Outcome Score (GOS) scoring system,there were 3 cases (12.5%) with no disability,2(8.3%) with mild disability,4(16.7%) with severe disability and 3(12.5%) with persistent vegetative state.The mortality rate of the common road group was 75%(39/52).There were 6 cases (11.6%) with no disability,4(7.7%) with mild disability,2(3.8%) with severe disability and 1(1.9%) with persistent vegetative state.Conclusion Mostly the trauma patients in highway group are male adults.The delivering time is longer than that in common road group.The proportion of multiinjury and the occurring rate of shock are higher than those in the highway group.Patients with 3 points by GCS score system are extremely difficult to survive.If patien