外伤后急性大脑半球肿胀诊治分析(附182例报告)  

Diagnosis and Treatment of Acute Cerebral Hemisphere Swelling (a Report of 182 Cases)

作　　者：陈焕雄[1] 曹作为[1] 金虎[1] 李钢[1] 颜山[1] 陈敏[1] 符俊琪[1] 

机构地区：[1]海口市人民医院神经外科,海南海口570208

出　　处：《中国临床神经外科杂志》2006年第11期672-673,共2页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨外伤后急性大脑半球肿胀(ACHS)的临床特点,CT、MRI影像学表现和治疗效果。方法对我院近8年来收治的182例ACHS患者采取去大骨瓣减压术治疗69例,过度通气+去大骨瓣减压术治疗113例。结果去大骨瓣减压术治疗的69例中,死亡20例,重残10例,中残9例,恢复良好30例;过度通气+去大骨瓣减压术治疗的113例中,死亡23例,重残14例,中残23例,恢复良好53例。结论对于ACHS患者,应及时采取有效治疗措施。有效地控制颅内压增高,建立足够的换气和循环通道,改善脑灌注压,是减轻继发性脑损害,提高抢救成功率,降低致残率的关键。Objective To explore the clinical characteristics, manifestations on CT and MRI and curative outcome of acute cerebral hemisphere swelling （ACHS）. Methods Of 182 patients with ACHS treated in our hospital in recently 8 years, 69 underwent big bone flap craniotomy and 113 both the big bone flap craniotomy and hyperventilation. Results Of 69 patients undergoing the big bone flap craniotomy, 20 died, 10 were severely disabled, 9 moderately disabled, and 30 recovered well. Of 113 patients undergoing the big bone flap craniotomy and hyperventilation, 23 died, 14 were severely disabled, 23 moderately disabled, and 53 recovered well. Conclusions The key measures to treat ACHS include the effectively controlling intracranial pressure, establishing sufficient ventilative and circulative routes and improving the cerebral perfusion pressure. These measures can reduce secondary brain injury, so the successful rate of treatment can be heightened and the disabled rate can be decreased in the patients with ACHS.

关 键 词：急性大脑半球肿胀 颅脑损伤 过度通气 去大骨瓣减压 

分 类 号：R651.11[医药卫生—外科学] R651.15[医药卫生—临床医学]