急性硬膜外血肿手术后颅内压影响因素分析  

Clinical analysis of influencing factors for intracranial pressure of acute epidural hematoma after operation.

作　　者：张国哲[1] 曹德晨[1] 姚鑫[1] 

机构地区：[1]天津市环湖医院,天津300060

出　　处：《浙江创伤外科》2007年第3期193-195,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探讨急性硬膜外血肿患者术后颅内压增高发生的机制及其影响因素和术中去骨瓣减压的指征。方法将65例急性硬膜外血肿患者分为颅内压显著增高组和颅内压正常或轻度增高组两组。根据患者格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)、瞳孔大小、血肿量、手术时间等进行统计学分析。结果两组在瞳孔进行性散大的差异有统计学意义(P<0．01);而在GCS评分、血肿量、手术时间等的差异无统计学意义。结论急性硬膜外血肿术后颅内压增高主要是急性脑受压造成的脑水肿;脑受压程度越重、时间越长,术后脑水肿越严重;及时手术是避免或减轻术后脑水肿的有效措施,对术后发生颅内压显著增高病例应及时去骨瓣减压。Objective To explore the mechanism of intracranial pressure and its influencing factors in acute epidural hematoma after operation and the signs of bony decompression. Methods 65 cases of acute epidural hematoma were divided into group with significant increase of intracranial pressure and group with little increase or normal intracranial pressure . Statistical analysis was based on GCS, diameter of pupils, amount of hematoma and operative time. Results The two groups had much significant difference in factor of progressive pupils expanding(P<0.01). GCS, amount of hematoma and operative time had no significant difference between groups. Conclusion Intracranial pressure increase of acute epidural hematoma after operation resulted by brain edema after acute brain oppression. The more serious and longer time of brain oppressed, the more severe brain edema caused after operation. Early operation can avoid and alleviate the edema. Bony decompression should be performed in time for the patients with intracranial pressure significant increase.

关 键 词：硬膜外血肿 颅内压 外科手术 

分 类 号：R64[医药卫生—外科学]