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目的探讨颅脑损伤合并多发伤的临床救治原则和处理。方法采集本科2006年4月至2009年2月入院的169例重症颅脑损伤合并多发伤患者进行临床资料研究,并对其救治过程进行回顾性分析。结果患者术后依照格拉斯哥结局量表GOS评分恢复良好65例(38.5%),轻残48例(28.4%),重残21例(12.4%),植物生存5例(3.0%),死亡30例(17.8%)。结论合理救治程序至关重要,重视院前急救和术后综合治疗,强调先重后轻,先开放后闭合的救治原则。早诊断早治疗能提高重型颅脑损伤合并多发伤的治疗效果,同时是减少致残率及降低死亡率的最佳选择。重型颅脑损伤合并多发伤应早期诊断,及时抢救,避免漏诊和误诊,首先处理危及生命的损伤以及专科治疗配合ICU监护是重型颅脑损伤合并多发伤救治成功的关键。
Objective To explore the principle and treatment of traumatic brain injury combined with multiple trauma. Methods A total of 169 cases of severe craniocerebral injury combined with multiple trauma admitted to our hospital from April 2006 to February 2009 were studied retrospectively. Results After operation, GOS score of Glasgow Outcome Scale returned to good in 65 cases (38.5%), mild disability (28.4%), severe disability in 21 cases (12.4%), plant survival in 5 cases (3.0%) and death in 30 cases (17.8%). Conclusions Reasonable treatment procedure is very important, emphasis on pre-hospital emergency and postoperative comprehensive treatment, emphasizing the principle of first aid and then light, and then closed after opening. Early diagnosis and early treatment can improve the treatment of severe traumatic brain injury combined with multiple injuries, and is the best choice to reduce morbidity and mortality. Severe craniocerebral injury with multiple injuries should be diagnosed early, timely rescue, to avoid misdiagnosis and missed diagnosis, the first to deal with life-threatening injuries and specialist treatment with ICU monitoring is the key to the success of severe traumatic brain injury combined with multiple injuries.