颅底骨折合并致命性口鼻腔大出血的急救处理

摘要

Objective To study the pathological anatomy of fatal skul fracture combined oral nasal bleeding, explore its first aid hemostasis. Methods From September 2011 to December 2012, 9 cases of fatal skull fracture combined oral nasal bleeding (bleeding>1000ml) were treated in our hospital, tracheotomy and improved oral nasal packing method were immediately used for each patient. Results 1 patient died of hemorrhagic shock ferocious, the remaining 8 cases achieved to a satisfactory hemostasis, including two patients died of multiple organ failure, survived 6 cases in 1 case bleeding again after removal of stuf ing, there was no delayed bleeding and intracranial infection. Conclusion Improved oral nasal packing method is simple, have the exact hemostasis, provide a basis for clarify the source of bleeding and further treatment.%目的：了解颅底骨折合并致命性口鼻腔大出血的病理解剖基础，探讨其急救止血方法。方法回顾我院2011年9月~2012年12月收治9例颅底骨折合并口鼻腔大出血(出血量>1000ml)患者的急救处理过程，均迅速给予气管切开，予改良口鼻腔填塞法止血。结果1例因出血凶猛死于休克，其余8例均取得到满意的止血效果，其中2例死于多器官功能衰竭，存活6例中有1例解除填塞后有再次出血，均无迟发出血及颅内感染发生。结论改良口鼻腔填塞法简单易行、止血效果确切，为明确出血来源及进一步治疗提供了基础。