急性重型颅脑损伤的院前急救体会

目的：探讨急性重型颅脑损伤的院前急救要点。方法：对本中心2009年1月~2011年1月抢救并转送的89例急性重型颅脑损伤病例进行回顾性分析,按性别、年龄、致伤原因、出车速度,主要症状、生命体征变化、格拉斯哥昏迷评分（以下简称GCS）、合并伤、院前急救措施、救治效果输入Excel表格进行统计分析。结果：急性重型颅脑损伤患者多为小于44岁的年轻人,男性患者多于女性患者,致伤原因主要为交通事故;院前通过气道维护、降颅压、控制出血、骨折固定,妥善搬运和抗休克等,将患者转送至有条件的医院接受治疗,病情平稳31.5%、病情好转50.6%、病情恶化15.7%、途中死亡2.2%。结论：积极有效的院前急救措施,对早期稳定病情、缓解症状、减少致残率和死亡率至关重要。

Pre-hospital care experience of acute severe craniocerebral injury

Objective： To investigate the key points in pre-hospital medical care of acute severe craniocerebral injury. Methods： Data of 89 cases of patients rescued and transferred in the author＇s hospital from January 2009 to January 2011 with acute severe craniocerebral injury were retrospectively analyzed. Sex, age, cause of injury, ambulance respond speed, the main symptoms, changes of vital signs, Glasgow coma score （hereinafter referred to as GCS）, associated injuries, pre-hospital emergency measures, outcome of rescue of the patients were entered in and analyzed with Excel. Results： Most of the cases analyzed were less than 44-year-olds, and there were more male patients than female patients. The main causes of the cases were road accidents. And the patients were transferred to qualified hospitals for treatment after pre-hospital airway maintenance, intracranial pressure release, bleeding control, fracture fixation, proper transporting and anti-shock measures. Condition of 31.5% of the patients went stable, 50.6% improved, 15.7% deteriorated, and 2.2% died on the way. Conclusion： Positive and effective pre-hospital emergency measures are the key to stabilize disease at an early stage, to relieve symptoms and to reduce morbidity and mortality.