颅脑损伤课件

汇报人：xxx20xx-03-14颅脑损伤ppt课件目录颅脑损伤概述头皮损伤颅骨损伤脑损伤颅脑损伤并发症与后遗症颅脑损伤治疗与康复01颅脑损伤概述定义颅脑损伤是指暴力作用于头颅引起的损伤，包括头部软zu织损伤、颅骨骨折和脑损伤。分类根据损伤部位可分为头皮损伤、颅骨损伤和脑损伤；根据损伤发生的时间和类型可分为原发性颅脑损伤和继发性颅脑损伤；根据颅腔内容物是否与外界交通可分为闭合性颅脑损伤和开放性颅脑损伤。定义与分类交通事故、高处坠落、失足跌倒、工伤事故和火器伤等；此外，难产和产钳引起的婴儿颅脑损伤、拳击和钝器打击等暴力行为也是颅脑损伤的常见原因。发病原因酗酒、吸毒、服用某些药物等会增加颅脑损伤的风险；同时，年龄、性别、职业等因素也可能与颅脑损伤的发生有关。危险因素发病原因及危险因素以下附赠各项管理制度英文版（不需要可删）急救药品、器材管理制度:1.Rescuedrugsandequipmentshouldbe"fivefixed"(fixedquantityandvariety,designatedplacement,designatedpersonstorage,regulardisinfectionandsterilization,regularinspectionandmaintenance)and"twotimely"(timelyinspectionandmaintenance,timelyreceiptandsupplementation).Theitemisclearlymarkedandcannotbeusedarbitrarily.2.Thenecessaryrescueequipmentiscomplete,ingoodperformance,andinstandbycondition.3.Therescuedrugsarecomplete,withcleardruglabelsandnodiscoloration,deterioration,expiration,ordamage.Theyshouldbeplacedandusedintheorderofdrugexpirationdates(fromrighttoleft).4.Emergencydrugsanditemsforeachdepartment'srescuevehicleshallbeuniformlyequippedaccordingtorequirements.Specializedemergencydrugsanditemsmustbereviewedandapprovedbythedepartmentdirectortodeterminethetype,quantity,specifications,anddosagetobeequipped.Rescuevehiclesmustbeplacedindesignatedlocationsandmanagedbydesignatedpersonneltoensuresafetyandeaseofuse.5.Afterusingrescuedrugsandequipment,theyshouldbefullyreplenishedwithin24hours.Iftheycannotbereplenishedduetospecialreasons,theyshouldbenotedonthehandoverregistrationformandreportedtotheheadnurseforcoordinationandresolutiontoensuretimelyuseduringpatientrescue.6.Thereisaregistrationbookfortheprovisionofdrugsandequipment.Ensureconsistencybetweenaccountsandmaterials,andhandoverbetweenshifts.7.Managementofsealedrescuevehicles:Beforesealing,theheadnurse(ornurseincharge)andanothernurseshallcountthedrugsandequipmentaccordingtotheregistrationbookofdrugandequipmentequipment,verifytheiraccuracy,andsealthemwithaseal.Twopeopleshallsignandfillinthesealingtime.Nurseschecktheconditionofthesealsoncepershiftandcompletethehandover.Theresponsiblenursescheckonceaweek,andtheheadnurseandresponsiblenursesopenthesealsandinspectthedrugsandequipmentintheambulanceonceamonth,withrecordskept.8.Nonsealedrescuevehiclemanagement:Eachshiftshallcountthedrugsandequipmentaccordingtotheregistrationbookandcompletethehandover.Theresponsiblenurseshallinspectonceaweek,andtheheadnurseshallinspectonceeverytwoweeksandkeeprecords,ensuringthattheaccountsmatchthematerials.护理文书书写制度:

1.Nursingstaffstrictlyfollowthelatestrequirementswhenwritingnursingmedicalrecords.2.Thecontentofnursingrecordsshouldbeobjective,truthful,accurate,timely,complete,andstandardized.3.Allnursingdocumentsshouldbewrittenwithablueblackorcarboninkpen.4.AllnursingdocumentsshouldbewritteninArabicnumeralsfordateandtime,withdatesinyears,months,anddays,usinga24-hoursystem,specifictominutes.5.WritingshoulduseChinese,medicalterminology,andcommonlyusedforeignlanguageabbreviations;Completerecorditems;Thetextisneat,thehandwritingisclear,andthelayoutisclean;Accurateexpression,fluentsentences,simpleandconcise:correctformatandpunctuation,notypos.6.Whenerrorsoccurduringthewritingprocess,doublelinethemonthewrongwords,keeptheoriginalrecordclearanddistinguishable,signthemodifier,indicatethemodificationtime,continuetowritethecorrectcontent,anddonotusescraping,sticking,paintingorothermethodstocoveruporremovetheoriginalhandwriting.Eachpageshouldbemodifiednomorethantwotimes,otherwisetheoriginalrecorderwillpromptlycopyagain(exceptformodificationsmadebysuperiors).7.Nursingrecordswrittenbyinternnurses,probationarynurses,orunregisterednursesshouldbereviewedandsignedbynurseswithlegalprofessionalqualificationsinthismedicalinstitution.8.Furthertrainingnursescanonlywritenursingdocumentsafterbeingrecognizedbythemedicalinstitutionreceivingthetrainingfortheirworkability.9.Superiornursingstaffhavetheresponsibilitytoreviewandmodifythewrittenrecordsofsubordinatenursingstaff.Whenmakingmodifications,reddoublelinesshouldbeusedtomarkerrors,writethemodifiedcontent,signandindicatethemodificationtime.10.Temperaturerecords,medicalorders,patientcarerecords,andsurgicalinventoryrecordsshouldbearchivedontime.临床表现头痛、呕吐、意识障碍、瞳孔改变、生命体征紊乱等；严重者可出现昏迷、瘫痪、失语、癫痫等症状。诊断依据详细询问病史，了解致伤原因、时间、地点及受伤时的姿势和伤后表现；进行全面的体格检查和神经系统检查，观察意识、瞳孔、肢体活动等情况；结合影像学检查如CT、MRI等明确诊断。临床表现与诊断依据02头皮损伤分类症状诊断治疗头皮血肿皮下血肿、帽状腱膜下血肿、骨膜下血肿根据病史、临床表现及影像学检查ju部肿块、疼痛、压痛等冷敷、加压包扎、穿刺抽吸或切开引流等单纯性头皮裂伤、复杂性头皮裂伤分类头皮裂口、出血、疼痛等症状根据病史、临床表现及伤口检查诊断清创缝合、止血、抗感染治疗等治疗头皮裂伤部分撕脱、完全撕脱分类症状诊断治疗头皮大片撕脱、出血、剧烈疼痛等根据病史、临床表现及伤口检查急救止血、清创缝合或植皮术等，注意预防休克和感染头皮撕脱伤03颅骨损伤呈线性，可单发或多发，骨折线不跨越颅缝。骨折线形态ju部疼痛、肿胀、头皮血肿等，一般无明显神经功能障碍。临床表现X线平片可显示骨折线，CT扫描可进一步明确骨折情况。影像学检查无需特殊治疗，但需密切观察病情变化，警惕颅内血肿形成。治疗原则颅盖骨线状骨折骨折部位颅底骨折多为线性骨折，可发生于颅前窝、颅中窝或颅后窝。临床表现根据骨折部位不同，可出现熊猫眼征、脑脊液鼻漏、耳漏、Battle征等表现。影像学检查CT扫描可显示骨折部位和程度，MRI可进一步明确软zu织和神经损伤情况。治疗原则保持耳、鼻清洁，避免用力擤鼻和堵塞耳道，应用抗生素预防感染，多数可自愈。颅底骨折ABCD凹陷性骨折骨折形态颅骨ju部向内凹陷，可压迫脑zu织，形成颅内血肿。影像学检查X线平片和CT扫描可显示骨折部位、程度和凹陷深度。临床表现ju部疼痛、肿胀、头皮血肿等，严重者可出现偏瘫、失语等神经功能障碍。治疗原则凹陷深度大于1cm或位于重要功能区者需手术治疗，否则可保守治疗并密切观察病情变化。04脑损伤1定义脑震荡是指头部遭受外力打击后，即刻发生短暂的脑功能障碍症状短暂的意识丧失、头痛、头晕、恶心、呕吐、注意力不集中等诊断主要依据临床表现，神经系统检查无阳性体征，CT检查颅内无异常治疗一般无需特殊治疗，卧床休息1-2周，可给予镇静剂、镇痛剂对症处理脑震荡治疗保持呼吸道通畅、控制颅内压、防治脑水肿、营养支持等定义弥漫性轴索损伤是指头部受到外伤作用后发生的，主要弥漫分布于脑白质、以轴索损伤为主要改变的一种原发性脑实质的损伤症状伤后立即出现意识障碍、瞳孔和眼球运动改变、生命体征紊乱等诊断CT和MRI检查可发现脑内出血、脑水肿等间接征象弥漫性轴索损伤定义脑挫裂伤是指暴力作用于头部，造成脑zu织的器质性损伤症状伤后立即出现意识障碍、局灶症状和体征明显、头痛、呕吐等颅内压增高表现诊断CT检查可明确脑挫裂伤的部位、范围和程度治疗保持呼吸道通畅、控制颅内压、防治脑水肿、营养支持、防治并发症等脑挫裂伤定义脑干损伤是指中脑、脑桥和延髓的损伤，是一种严重的颅脑损伤症状伤后立即出现持续昏迷、瞳孔和眼球运动改变、生命体征紊乱等诊断MRI检查可明确脑干损伤的部位和程度治疗保持呼吸道通畅、控制颅内压、防治脑水肿、营养支持、防治并发症等。对于严重的脑干损伤，可能需要采取手术治疗。但由于脑干是生命中枢，手术风险极大，需要严格掌握手术指征。01020304脑干损伤05颅脑损伤并发症与后遗症颅脑损伤后，血管破裂导致血液聚集在颅内形成血肿，压迫脑zu织，引起颅内压增高，严重时可导致脑疝。颅内血肿颅脑损伤后，脑细胞受损，导致水分在脑细胞内聚集，引起脑水肿，加重颅内压增高。脑水肿头痛、呕吐、意识障碍等，严重时可出现生命体征紊乱。临床表现密切观察病情变化，及时采取手术治疗清除血肿或药物治疗降低颅内压