182例特重型颅脑损伤的死亡原因分析

目的分析特重型颅脑损伤的死亡原因，总结特重型颅脑损伤的救治经验。方法回顾性分析182例特重型颅脑损伤患者的临床资料，选择12个相关死亡原因进行统计分析及总结。结果182例特重型颅脑损伤的死亡率为67．58％，相关死亡原因中受伤原因、入院时GCS评分之间差异无统计学意义（P〉0．05）；院前急救情况、损伤类型之间差异有统计学意义（P〈0．05），瞳孔的变化、基底池评分、手术情况、血氧水平、血糖水平、合并伤、并发症之间差异有统计学意义（P〈0．01）。结论特重型颅脑损伤死亡原因复杂，死亡率高，死亡因素与院前急救不及时、脑疝晚期、脑损伤程度、低血氧、高血糖、合并伤、并发症等有关；主要死亡原因是脑疝和肺部并发症。

Analysis ofthe death causation in 182 patients with special fulminant craniocerebral injury

Objective To analyze the death causation of special severe craniocerebral inju- ry, to summarize the treatment experiences of severe craniocerebral injury. Methods Aretrospec- tire analysis of the clinical data of 182 patients with special severe craniocerebral injury, to select the 2 related causes of death and summary statistics analysis. Results The mortality rate of se- vere craniocerebral injury in 182 cases was 67. 58%, there was no significant difference between admission GCS score and Cause of injury in related causes of death （P〉0. 05）; the pre hospital e- mergency situation between the difference stype of injury was statistically significant （P〈0.05） The change of pupil, basal cistern scores, operation condition, blood oxygen level, blood sugar level combined injury, complications, the difference was statistically significant （P〈0.01）. Con- clusion Severe craniocerebral injury death causes is complicated and high mortality, causes of death are relevant to the pre hospital emergency treatment untimely, degree of brain damage, ad- vanced cerebral hernia, low oxygen, high blood sugar, associated injury, complications and so on; the main death causes are cerebral hernia and pulmonary complications.