【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 characteristics of severe cerebral trauma in children and pertinent treatment. 【Method】 The influences of various risk factors on the prognosis were analyzed by statistics. 【Results】 Among the 45 children with severe cerebral trauma,6(13.33%)died.The degree of primary trauma influced the prognosis.32 patients with GCS between 5 and 8 survival,the survival rate was 71.11%,whereas 7 patients with GCS lower than 5 survived, the survival rate was 15.56%.Diffuse cerebral swelling and cerebral edema after trauma was an major risk factor influencing the prognoses. 【Conclusion】 After craniocerebral injury childrens tolerance on intracranial hypertension is poor and the change of the patients condition is rapid.Close observation of mind,pupil and GCS scoring and dynamic observation of CT is key to judge the injury condition.During treatment,ICP monitoring has important clinical significance.