Gobiet W
Neurologische Klinik, Bund Deutscher Hirnbeschädigter, Hessisch Oldendorf.
Zentralbl Chir. 1995;120(7):544-50.
The aim of this investigation was to proof, wether there is a direct influence of polytrauma on rehabilitation and outcome in patients with severe head injury (SHI). 558 patients were investigated 3 years after the accident. 82% (447) had combined SHI and polytrauma. Patients with polytrauma and similar degrees of SHI showed significantly poorer outcome than those with isolated SHI. The healing process in the rehabilitation hospital was complicated especially by tracheo-pulmonary factors and wrong bedding factors (atrophi, calcification, decubital ulcers). It can be concluded, that diagnostics and operative treatment must be done under continuous intensive and neuromonitoring. Only life-saving operations should be done in the acute stage. All patients with moderate and severe head injury need early rehabilitation parallel to the intensive care treatment.
本研究的目的是验证多发伤是否对重型颅脑损伤（SHI）患者的康复及预后有直接影响。事故发生3年后对558例患者进行了调查。82%（447例）患者合并有重型颅脑损伤和多发伤。多发伤且重型颅脑损伤程度相似的患者，其预后明显比单纯重型颅脑损伤患者差。康复医院的愈合过程尤其因气管-肺部因素和不当的卧床因素（萎缩、钙化、压疮）而变得复杂。可以得出结论，诊断和手术治疗必须在持续的重症监护和神经监测下进行。急性期仅应进行挽救生命的手术。所有中重度颅脑损伤患者在重症监护治疗的同时需要早期康复。
