| 周贵勤 陈召 毛景涛 王居正 王武平 张继朋 卢强.重症颅脑损伤合并胸外伤患者的救治和预后研究[J].,2017,17(3):470-472 |
| 重症颅脑损伤合并胸外伤患者的救治和预后研究 |
| Research of the Prognosis of Patients with Severe Craniocerebral Injurycombined with Thoracic Trauma |
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| DOI： |
| 中文关键词: 重症颅脑损伤 胸外伤 救治 预后 |
| 英文关键词: Severe traumatic brain injury Thoracic trauma Treatment Prognosis |
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| 中文摘要: |
| 目的：探讨重症颅脑损伤合并胸外伤患者的临床救治要点和预后。方法：对2006 年1 月至2015 年12 月陕西省森工医院收
治的重型颅脑损伤及重型颅脑损伤合并胸外伤患者的临床资料进行回顾性研究，并随访观察其预后情况。结果：我院10 年间收
治单纯重症颅脑损伤患者137 例及重症颅脑损伤合并胸外伤患者86 例，单纯重症颅脑损伤患者死亡率为9.5(13/137)，主要死亡
原因为：脑内出血(36/26.3%)、脑挫裂伤(31/22.6%)、呼吸衰竭(27/19.7%)等；重症颅脑损伤合并胸外伤患者死亡率为17.4(15/86)，主
要死亡原因为：呼吸衰竭(18/20.9%)、脑挫裂伤(18/20.9%)、脑内出血(15/17.4%)等。单纯重症颅脑损伤患者手术时间为187.6± 11.3
分钟、术后住院时间为10.9± 1.8 天、肢体运动障碍12 例(8.8%)、植物生存2 例(1.5%)；重症颅脑损伤合并胸外伤患者手术时间为
265.4± 18.9 分钟、术后住院时间为14.3± 2.1 天、肢体运动障碍10 例(11.6%)、植物生存3 例(3.5%)。其中，两组间在手术时间、术
后住院时间及肢体运动障碍方面有统计学差异。结论：重症颅脑损伤合并胸外伤较单纯重症颅脑损伤的致死率更高，手术时间
长，术后并发症发生率更高，术后住院天数较长。对于重症颅脑损伤合并胸外伤的患者，应尽量保全肢体功能，提高患者存活率和
术后生活质量。 |
| 英文摘要: |
| Objective:Analysis of clinical treatment and prognosis of patients with severe craniocerebral injury or combined with
thoracic trauma.Methods:The clinical data of patients with severe craniocerebral injury or combined with thoracic trauma from January
2006 to December 2015 were retrospectively studied from Shaanxi Provincial Forestry hospital.Results:In our hospital, 137 cases of severe
craniocerebral injury and 86 cases of severe craniocerebral injury combined with thoracic trauma were treated in our hospital during
the past 10 years. The death rate of patients with severe craniocerebral injury was 9.5 (13/137), the main causes of death were: intracerebral
hemorrhage (36/26.3%), brain contusion (31/22.6%), respiratory failure (27/19.7%) and the mortality rate of patients with severe
craniocerebral injury combined with thoracic injury was 17.4 (15/86), the main causes of death were: respiratory failure (18/20.9%), brain
contusion (18/20.9%), intracerebral hemorrhage (15/17.4%) and so on. The operation time of patients with severe craniocerebral injury
was 187.6± 11.3 minutes, postoperative hospitalization time was 12± 1.8 days, 10.9 (8.8%) cases of limb movement disorder,2 (1.5%)
cases of plant survival. The operation time of patients with severe craniocerebral injury combined with thoracic trauma was 265.4± 18.9
minutes, postoperative hospitalization time was 10± 2.1 days, 14.3 (11.6%) cases of limb movement disorder,3 (3.5%) cases of plant
survival. Among them, there were statistically significant differences in operation time, postoperative hospital stay and limb movement
disorder between the two groups.Conclusion:The death rate of severe craniocerebral injury combined with thoracic trauma is higher than
that of simple severe craniocerebral injury, the operation time is longer, the incidence of postoperative complications is higher and the
length of stay is longer. The limb function of patients with severe craniocerebral injury combined with thoracic trauma should be preserved
as far as possible to improve the survival rate of patients and postoperative quality of life. |
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