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目的分析重型颅脑损伤死亡的原因,探讨降低死亡率的可行措施。方法选取146例重型颅脑损伤患者,对其脑水肿、脑肿胀、颅内高压等致死因素进行分析。结果 146例患者中,入院后24 h内死亡36例(24.65%),24 h后死亡11例(7.53%),死亡率达32.2%。死亡原因主要有:合并伤伴休克(17.0%)、弥漫性轴索损伤(12.8%)、多发脑挫裂伤伴脑肿胀(48.9%)、原发性脑干损伤继发颅内损伤(21.3%)。结论导致重型颅脑损伤患者死亡的主要原因为患者颅内高压、血肿及脑肿胀等并发症;对患者及时进行诊断,并有效降低患者颅内压是早期降低死亡率的关键。
Objective To analyze the causes of death from severe craniocerebral injury and to explore possible measures to reduce mortality. Methods A total of 146 cases of severe craniocerebral injury were selected and their lethal factors such as cerebral edema, brain swelling and intracranial hypertension were analyzed. Results Of the 146 patients, 36 (24.65%) died within 24 hours after admission and 11 (7.53%) died after 24 hours, with a mortality rate of 32.2%. The main causes of death were combined injury with shock (17.0%), diffuse axonal injury (12.8%), multiple brain contusion and brain swelling (48.9%), primary brain injury secondary to intracranial injury (21.3 %). Conclusion The main cause of death in patients with severe craniocerebral injury is intracranial hypertension, hematoma and brain swelling. The timely diagnosis and reduction of intracranial pressure in patients with intracranial hypertension is the key to early mortality reduction.