【摘 要】 目的 回顾性分析交通事故致重度颅脑损伤合并严重胸外伤的救治，探讨此类损伤的临床特点和救治原则。 方法 28例交通事故致重度颅脑损伤合并严重胸外伤患者，均为重度颅脑伤(GCS3～8分)合并严重胸外伤，入院时低血压甚至休克。立即给予畅通气道，积极抗休克。急诊行颅内血肿清除术9例，胸腔闭式引流25例，开胸手术5例。建立人工气道后，均予以机械辅助/控制通气，常规使用呼吸末正压呼吸(PEEP)。 结果 治愈19例，死亡9例。5例死于重度颅脑损伤，3例死于迁延性昏迷并发多器官功能衰竭(MOF)，1例死于ARDS。 结论 交通事故致头胸严重伤常见，因两者病理生理改变显著且互为因果，给临床诊治带来更多困难。优先稳定呼吸、循环，及时解决颅脑及胸部致命性损伤，结合积极、合理的机械通气等综合措施，有望降低此类患者死亡率、致残率。

    【关键词】 交通伤;颅脑损伤;胸部损伤;重度;治疗结果

    Treatment of traffic accident┐incurred grave craniocerebral injury combined with severe thoracic injury(28case refports at┐tached) ZHANG Zhi-tian，CHUI Ying，HUANG Jun-jie，et al.(Huaiyuan Second People's Hospital，Anhui233400，China)

    【Abstract】 Objective To analyse the treatment of traffic accident-incurred grave craniocerebral injury combined with severe thoracic injury retrospectively and explore the clinicl features and principles applied in the treatment.Methods The28cases were all grave craniocerebral injury(GCS3～8scores)caused by traffic accident and combined with severe thoracic injury with low blood pressure and shock on admission.Measures of clearing air passage and anti-shock were taken.9cases were given im-mediate intracranial hematoma evacuation ......