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【目的】分析儿童重型颅脑创伤的临床特点、针对性治疗措施及对预后的影响。【方法】用统计学方法分析各种危险因素对预后的影响。【结果】45例重型颅脑创伤患儿,死亡6例(13.33%),预后与原发性损伤的严重程度有关,GCS评分5～8分者存活32例,存活率71.11%,评分5分者7例,存活率15.56%。外伤性弥漫性脑肿胀、脑水肿是影响预后的主要因素;帽状腱膜下血肿和呼吸道误吸是重要的潜在危险因素。【结论】儿童颅脑损伤后,对颅内高压的耐受性差,病情变化快。神志、瞳孔和GCS评分的严密观察是判断伤情的关键.颅内压监测(ICP)在治疗中有重要意义。
【Objective】 To analyze the clinical features, targeted treatment and prognosis of children with severe traumatic brain injury. 【Methods】 Statistical analysis of the impact of various risk factors on prognosis. 【Results】 There were 6 deaths (13.33%) in 45 children with severe craniocerebral trauma. The prognosis was related to the severity of primary injury. 32 patients survived with GCS score 5 ~ 8, survival rate was 71.11% and score was 5 In 7 cases, the survival rate was 15.56%. Traumatic diffuse brain swelling and cerebral edema are the main factors that influence the prognosis. Cap-like subdural hematoma and respiratory aspiration are important potential risk factors. 【Conclusion】 Children with craniocerebral injury have poor tolerance to intracranial hypertension and their condition changes rapidly. Close observation of the mind, pupil, and GCS score is the key to assessing the condition of the injury, and ICP (intracranial pressure monitoring) is important in the treatment.