Treatment strategies for brain hernia combined with hemorrhagic shock following severe traumatic brain injury

Abstract:

Objective：To explore emergency treatment strategies for patients with brain hernia combined with hemorrhagic shock after severe traumatic brain injury and to discuss their effects on prognosis． Methods：A retrospective analysis was made on 32 patients（ob－servation group） with brain hernia combined with hemorrhagic shock treated by selective strategies on the basis of integrative strate－gies from September 2009 to April 2011；another 22 patients（control group） with the same injuries were treated by routine strategies. Mortality within one week and glasgow outcome score（GOS） at six months after injury were compared between two groups. Results：Mortality rate was 34.4%（11/32） in observation group and 45.5%（10/22） in control group two weeks later（P >0.05）. GOS disability rating（Ⅰ，Ⅱ level） were higher in observation group than in control group at six months after injury；GOS disability rating（Ⅲ，Ⅴ level） were lower in observation group than in control group at six months after injury（ ?字2=4.909，P=0.027）. Conclusions：Early se－lective strategies based on degree of shock combined with integrative strategies may obtain better outcome for patients with brain her－nia combined with hemorrhagic shock after severe brain injury.