How to treat severe closed craniocerebral injury?
summary
Severe closed craniocerebral injury refers to the brain injury with intact dura mater. Although there are open wounds on the scalp and exposed bones, the contents of the cranial cavity do not communicate with the outside world, so it is still called closed craniocerebral injury. Most of the injuries were caused by traffic accidents, falls, falls and birth injuries. So how to treat severe closed craniocerebral injury? Here are a few points to help you.
How to treat severe closed craniocerebral injury?
Method 1: prevention and treatment of brain edema, reduce intracranial pressure, treatment of lying position. Except for shock patients, all patients were in high head position; ② Limit the intake, correct the imbalance of water and salt metabolism, and give enough vitamins (cephalosporins, ofloxacin, metronidazole); ③ Dehydration treatment. It is effective to eliminate brain edema (mannitol) and reduce intracranial pressure; ④ Continuous external ventricular drainage or intermittent release of a certain amount of cerebrospinal fluid in patients with intracranial pressure monitoring, or lumbar puncture release an appropriate amount of cerebrospinal fluid when the condition is stable; ⑤ Hibernation, mild hypothermia therapy. It can reduce the metabolism of brain, reduce the oxygen consumption of brain tissue, prevent the occurrence and development of brain edema, and also play a certain role in reducing intracranial pressure; ⑥ Barbital treatment. It can reduce brain metabolism, reduce oxygen consumption, increase brain tolerance to hypoxia and reduce intracranial pressure. ⑦ Mechanical assisted hyperventilation therapy. The purpose is to make the body CO2 emissions, can make the cerebral blood flow decreased, so that the intracranial pressure decreased; ⑧ Hormone therapy. The application of hormone therapy in eliminating brain edema and relieving intracranial hypertension is still controversial.
Method 2: the purpose of surgical treatment is to remove intracranial hematoma and other space occupying lesions, so as to relieve intracranial hypertension, prevent the formation of cerebral hernia or relieve cerebral hernia. The operation includes: skull drilling exploration, hematoma clearance and brain tissue debridement and decompression. In order to prevent complications and strengthen nursing, we should mainly prevent pulmonary and urinary tract infection in the early stage, and ensure nutrition supply, prevent bedsore and strengthen functional training in the late stage.
Method 3: keep the respiratory tract unobstructed, closely observe the condition, check the changes of respiration, pulse, blood pressure, consciousness and pupil at any time, and pay attention to whether there are new symptoms and signs. The application of neurotrophic drugs can be selected or combined according to the patient's condition.
matters needing attention
Up to now, there is no better treatment for closed craniocerebral injury. In our country, the disease can be divided into three types: mild, severe and moderate. The situation of different types of intracranial injury is different. If it is the most serious, the patient will have deep coma. If the disease cannot be cured within 12 hours of deep coma, It's likely to take the patient's life.
