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目的探讨小儿重型颅脑损伤的临床特点与急诊抢救。方法回顾性分析48例小儿重型颅脑损伤患儿的临床资料与急救经过。结果送手术室手术20例(其中开颅手术16例,前囟穿刺置管引流血肿2例,脾切除2例),非手术治疗26例。按GOS预后评分:恢复良好30例(62.50%),中残8例(16.67%),重残4例(8.33%),植物生存2例(4.17%),死亡4例(8.33%),其中2例双侧瞳孔散大患儿在急诊科抢救无效死亡,2例死于多器官功能衰竭。结论掌握小儿重型颅脑损伤的临床特点,建立规范的急救程序,树立创伤救治“黄金1 h”的时间观念,减少急诊抢救时间,尽早进行确定性手术治疗,可提高急诊抢救成功率,降低致残率和死亡率。
Objective To investigate the clinical features and emergency treatment of pediatric severe craniocerebral injury. Methods Retrospective analysis of 48 cases of children with severe craniocerebral injury clinical data and first aid after. RESULTS: Twenty patients underwent surgical operation (craniotomy was performed in 16 cases, anterior fontanel puncture and catheter drainage hematoma in 2 cases and splenectomy in 2 cases). Nonoperative treatment was performed in 26 cases. According to the GOS prognosis score, 30 cases (62.50%) recovered well, 8 cases (16.67%) had severe disability, 4 cases (8.31%) had severe disability, 2 cases (4.17%) had plant survival and 4 (8.33%) died Two patients with bilateral mydriasis were ineffective in the emergency department and two died of multiple organ failure. Conclusion To grasp the clinical features of pediatric severe craniocerebral injury, to establish a standardized first aid procedure and to establish the concept of time of trauma treatment “Golden 1 h”, to reduce emergency treatment time and to carry out definitive surgical treatment as soon as possible to improve the emergency rescue success rate, Reduce morbidity and mortality.