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目的：总结PICU收治重型颅脑损伤患儿的临床特点及影响预后的相关因素。方法回顾性分析2013年2月-2015年1月入住北京儿童医院儿童重症监护病房（PICU）的重型颅脑损伤病例50例。对年龄、性别、伤因、伤型、GCS评分、脑疝形成、血糖、血钠等临床资料进行分析，并讨论影响预后的相关因素。结果儿童重型颅脑损伤最常见的原因是车祸伤、坠落伤。原发性脑损伤30例（60%），继发性脑损伤20例（40%）。合并呼吸衰竭需机械通气36例（72.0%），症状性癫痫17例（34%）。恢复良好24例（48%），死亡14例（28%）。脑疝组的死亡率（45.5%）显著高于非脑疝组（14.3%），死亡组的GCS评分（3.57±1.28）明显低于存活组（6.00±1.53），差异有统计学意义。结论儿童重型颅脑损伤的临床特点是原发性颅脑损伤症状表现重，容易合并呼吸衰竭、癫痫等情况。低GCS评分及脑疝形成是影响预后的重要因素。“,”Objective To summarize the clinical features and analysis of prognostic factors of severe traumatic brain injury in pediatric intensive care unit (PICU). Methods A retrospective analysis was conducted on a total of 50 children who suffered from severe brain injury hospitalized from February 2013 to January 2015. The clinical data included age, sex, causes of injury, types of injury, Glasgow Coma Scale (GCS), herniation of brain, blood glucose and sodium. The influencing factors to the prognosis were also analyzed. Results The main causes of severe traumatic brain injury were traffic accident and fall. There were 30 cases of primary brain injury and 20 cases of secondary brain injury. 36 children with respiratory failure were given ventilation. 17 children had epilepsy. 24 patients (48%) showed a good outcome, while 14 patients (28%) died. There was a significant difference in death rate between the hernia group and non-hernia group (45.5%VS.14.3%, P<0.05). GCS score of death group was less than the survival group (3.57 ± 1.28 VS.6.00 ± 1.53, P<0.01). Conclusion The main clinical characteristics of children with severe traumatic brain injury include severe primary brain injury and prone to respiratory failure and epilepsy. Low GCS score and herniation of brain were considered being remarkable factors to the prognosis.