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目的:探讨降低颅脑外伤后双瞳孔散大(外伤所致原发性动眼神经受损及低血压所致不在此统计范畴内)患者的死亡率和提高生存质量的方法。方法:39例双瞳孔散大患者行急症手术,术前给予脱水药物,术后给予ICU监护,并控制中枢性高热,维持通气及改善缺氧,其余患者行保守治疗。结果:良好5例,中残9例,重残11例,植物生存11例,家属放弃治疗10例,死亡15例。结论:救治生存率逐年提高,但植物生存概率较高。影响预后因素与开始手术时间的快慢、瞳孔散大的速度、受伤部位及年龄大小关系密切。
Objective: To explore ways to reduce the mortality and improve the quality of life of patients with bilateral mydriasis after traumatic brain injury (the primary oculomotor nerve damage caused by trauma and the hypotension caused by hypotension). Methods: Thirty-nine patients with double-mydriasis were treated with acute surgery. Preoperative dehydration was given. ICU was administered after the operation, and central hyperthermia was controlled. Ventilation and hypoxia were maintained. The remaining patients underwent conservative treatment. Results: 5 were in good condition, 9 were moderate disability, 11 were severe disability, 11 were plant survival, 10 were given up for treatment by family members and 15 were died. Conclusion: The survival rate of treatment increases year by year, but the survival rate of plants is higher. Prognostic factors affect the speed of the start of surgery, the speed of dilated pupils, the site of injury and the age of the close relationship.