目的　分析总结小儿重型颅脑损伤的临床特点。方法　回顾性研究小儿重型颅脑损伤患者的致伤原因、损伤类型、临床表现 ,以及救治方法和预后状况。结果　本组共 4 5 8例 ,男性 317例 ,女性 14 1例。年龄 1个月～ 15岁。车祸伤 185例 ,坠落伤 15 9例 ,二者合计占 75 .1%。闭合性颅脑损伤 35 7例 ,开放性颅脑损伤 10 1例。合并颅内血肿 16 2例 (35 .4 % ) ;并发颅骨骨折 2 2 1例 ,其中凹陷骨折 82例。全组均有不同程度的意识障碍 ,有生命体征变化 2 5 3例 (5 5 .2 % ) ;癫痫发作 10 7例(2 3.4 % )。 36 7例施行血肿清除、去骨瓣减压、凹陷骨折复位术等手术治疗 ,另外 91例保守治疗。恢复良好 337例 (73.6 % ) ;中残 2 7例 (5 .9% ) ;重残 12例 (2 .6 % ) ;植物生存 7例 (1.5 % ) ;死亡 75例(16 .4 % )。结论　小儿重型颅脑损伤的主要临床特点是原发性脑损伤表现重 ;生命体征紊乱明显 ;颅骨凹陷骨折和颅缝分离多见 ;囟门闭合前后临床特征不同 ;对冲性颅内血肿发生率低 ;癫痫发生率高 ;预后较成人好 Objective To summarize the clinical features of pediatric severe craniocerebral injury. Methods Retrospective study of pediatric patients with severe craniocerebral injury cause of injury, type of injury, clinical manifestations, and treatment methods and prognosis. Results There were 458 cases in this group, including 317 males and 141 females. Aged from 1 month to 15 years old. 185 cases of car accident injuries, 15 9 cases of falls, the two together accounted for 75.1%. 357 closed craniocerebral injury and 101 open craniocerebral injury. There were 162 cases (35.4%) with intracranial hematoma and 21 cases with craniofacial fractures, of which 82 cases were sagittal fractures. There were 253 (55.2%) changes in vital signs and 107 (2.3%) seizures in all groups with different degrees of disturbance of consciousness. 367 cases of hematoma removal, decompressive craniectomy, depression fracture reduction and other surgical treatment, the other 91 cases of conservative treatment. 337 cases (73.6%) recovered well, 27 cases (5.9%) had moderate disability, 12 cases (2.5%) severely disabled, 7 cases (1.5%) plant survival and 75 cases (16.4% . Conclusions The main clinical features of children with severe craniocerebral injury are severe brain injury, obvious vital signs, skull fracture and cranial suture separation, different clinical features before and after fontanel closure, low incidence of hemorrhagic hematoma, High incidence of epilepsy; prognosis better than adults