中华创伤杂志英文版040312

	中华创伤杂志英文版 CHINESE JOURNAL OF TRAUMATOLOGY 2004 Vol.7 No.3 P.184-187

Clinical analysis of craniocerebral trauma complicated with thoracoabdominal injuries in 2 165 cases

CHEN Wei-qun 陈卫群（Neurosurgery Department, Longgang Central Hospital,Shenzhen 518116, China）　
WANG Gang 王刚（People's Hospital, Bao-an, Shenzhen 518101, China）　
ZHAO Wan 赵万（People's Hospital, Bu-ji, Shenzhen 518112, China）　
HE Liang-zhen 何亮珍　

Abstract：Objective: To explore the optimal treatment for craniocerebral trauma complicated with thoraco-abdominal injuries.Methods: A total of 2 165 cases of craniocerebral trauma complicated with thoraco-abdominal injuries admitted to our hospital between July 1993 and June 2003 were retrospectively studied. Among them, 382 cases sustained severe craniocerebral trauma (in which 167 were complicated with shock ), 733 thoracic injuries, 645 abdominal injuries and 787 thoraco-abdominal injuries. On admittance, 294 cases had developed shock. With the prime goal of saving life, respiratory and circulatory systems and encephalothilipsis were especially treated and monitored.Priority in management was directed to severe or open injures rather than to moderate or closed injures. For cases with cerebral hernia due to intracranial hematoma and severe shock due to blood loss, cerebral hernia and shock were treated concurrently.Results: After treatment, 2024 ( 93.49 % ) cases survived and the other 141 (6.51%) died. Among patients who had severe craniocerebral injury with shock and those without, 78 (46.71%) and 53 (24.56%) died,respectively. For patients who had underwent craniocerebral and thoraco-abdominal operations concurrently and those who had not, the death rates were 58.49%-65.96% and 28.57 % respectively, indicating a significant difference ( P ＜ 0.05 ).Conclusions: Treatment for hematoma hernia, shock and disturbed respiration is the key in the management of multiple trauma of craniocerebral, thoracic or abdominal injuries, especially when two or three conditions occurred simultaneously. Unless it is necessary, operations at two different parts at the same time is not recommended. It is preferred to start two concurrent operations at different time.
Keywords：Craniocerebral trauma; Thoracoabdominal injuries

Author Resume：CHEN Wei-qun 陈卫群,Corresponding author: Tel: 86-755-84806933, E-mail:chenweiqun47@ yahoo. com. cn

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Manuscript Received：2003年11月24日

Published：2004年6月1日

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