ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG, HÌNH ẢNH HỌC VÀ KẾT QUẢ ĐIỀU TRỊ BỆNH NHÂN CHẤN THƯƠNG SỌ NÃO NẶNG TẠI KHOA HỒI SỨC TÍCH CỰC NGOẠI KHOA, BỆNH VIỆN HỮU NGHỊ ĐA KHOA NGHỆ AN

Abstract

Objective: to describe the clinical, laboratory, imaging characteristics and treatment results of patients with severe traumatic brain injury at the surgical intensive care unit of Nghe An General Friendship Hospital. Subjects and methods: cross-sectional descriptive study on 51 patients with severe traumatic brain injury who undergone brain decompression surgery, and were under post-operative treatment at the surgical intensive care unit, Nghe An General Friendship Hospital from October 2022 to June 2023. Results: The largest age group was 40-59 years old (41.2%). Male patients made up the majority with 86.3%. Traffic accidents were the most common cause with 78.4%. Glasgow coma score at admission was 6 - 8 points, accounting for 94.1%. 37.3% of cases had dilated pupils and loss of light reflex on one side, and 3.9% of cases had dilated pupils and loss of light reflex on both sides. 19.6% of patients had images of arachnoid bleeding. Subdural hematoma was the most common lesion with a rate of 45.1%. 19.6% of patients had combined lesions. The majority had midline displacement of 6-10 mm, accounting for 66.7%. 45.1% of patients had basal cisternae with compression and opacification of varying degrees. The proportion of patients with a Rotterdam score of 5 accounting for 7.8%. The death rate after 1 month was 11.8%, the proportion of patients with good outcome after treatment was 56.9%. The average number of treatment duration was 20.47 ± 11.83 days, the average number of postoperative duration was 19.70 ± 11.81 days. Conclusion: Clinical features and computed tomography images in patients with severe traumatic brain injury are diverse. With the improvement of surgical techniques and post-operative management, the mortality rate and serious sequelae of patients with traumatic brain injury have decreased significantly.