中国儿童保健杂志 ›› 2012, Vol. 20 ›› Issue (1): 86-87.

• 经验交流 • 上一篇    下一篇

意外伤害致儿童重型颅脑创伤45例诊治分析

赵卫平,郝成仁,冯勇,吴日乐   

  1. 内蒙古自治区人民医院神经外科,内蒙古 呼和浩特 010017
  • 收稿日期:2011-11-19 发布日期:2012-12-06 出版日期:2012-01-06
  • 作者简介:赵卫平(1978-),男,内蒙古人,主治医师,硕士学位,主要从事神经外科临床工作

Clinical characteristics pertinent treatment and prognosis of severe cerebral trauma in children

ZHAO Wei-ping,HAO Cheng-ren,FENG Yong,WU Ri-le   

  1. Hospitai of Inner Mongolia,Huhhot,Neimenggu 010017,China
  • Received:2011-11-19 Online:2012-01-06 Published:2012-12-06

摘要: 【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。

关键词: 重型颅脑创伤, 预后, 治疗措施, 儿童

Abstract: 【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.

Key words: severe cerebral trauma, prognosis, treatment, children

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