【摘要】 目的 寻找颅脑、胸、腹多发伤的最佳治疗途径。方法 回顾性分析1993年7月～2003年6月间收治的2165例颅脑损伤合并胸腹外伤病例。颅脑合并胸部伤733例，腹部伤645例，胸腹联合伤787例，其中294例并发休克。全部病例中重型颅脑伤382例，其中167例合并休克。治疗原则是以抢救生命为主，抓好呼吸、循环、脑受压三个环节，先重后轻，先开放后闭合，颅内血肿脑疝并失血重度休克者两个部位同时手术。结果 总救治成功2024例(93.49%)，总死亡141例(6.51%)，重型颅脑伤无休克者，死亡53例(24.65%)，合并休克者死亡78例(46.71%)。两个部位手术时间完全重叠的患者死亡率58.49%～65.96%，两个部位手术时间部分错开的患者死亡率28.57%，两者相比差异有显著性(P<0.05)。结论 颅脑、胸、腹多发伤的治疗重点是颅内血肿脑疝、休克和呼吸障碍，尤其是两种以上情况同时发生时。各部位治疗应相互兼顾，必要时两个部位同时手术，但只要病情允许，同时进行的两台手术的开始时间部分错开为宜。

    关键词 颅脑损伤 胸腹合并伤 临床分析

    The clinical analysis of brain injury combined with chest and/or abdomen injury in2165cases

    Tu Changdi，Chen Weiqun，Tan Qiang，et al.

    Department of Emergency Surgery，Longgang Central Hospital，Shenzhen518116

    【Abstract】 Objective To look for the best method in treatment of the cases with the brain，chest and abˉdomen injury.Methods 2165cases brain injury with the chest and/or abdomen injury which were in hospital from July1993to June2003were summarized and researched.The patients with the severe brain injury were382cases，in which167cases had shock.The patients with chest injury were733cases.The patients with abdomen injury were645cases.The patients with both chest and abdomen injury were787cases.The patients with shock were294cases when just arrived the hospital.The treatment principle was to save the patients life firstly ......