外伤性张力性气颅的手术治疗  

Surgery treatment of traumatic tension pneumocephalus

作　　者：李谷[1] 李立[1] 沈罡[1] 温良[1] 虞军[1] 

机构地区：[1]浙江大学医学院附属第二医院神经外科,浙江杭州310009

出　　处：《全科医学临床与教育》2007年第1期14-16,共3页Clinical Education of General Practice

摘　　要：目的探讨外伤性张力性气颅的临床诊断、发病机制、治疗以及预防措施。方法分析12例外伤性张力性气颅的临床特点、影像学特征、手术处理方法以及预后。结果12例中3例行急诊钻孔排气术、9例行开颅气体排除并血肿清除或瘘口修补术,术后均恢复良好。所有患者颅内气体均在2-4周内吸收,术后未发现复发或原有临床症状迹象,均治愈出院。结论对于脑外伤,尤其有颅底骨折、额骨骨折病史的患者,应警惕张力性气颅的产生。及时行头颅X片、CT、MRI等检查,尤其是MRI对诊断和手术治疗可提供较大帮助。明确诊断后可以结合患者当时情况行急诊或择期手术,彻底根除张力性气颅产生的根源。Objective To discuss the diagnosis, pathogenesis, treatment and prevention of traumatic tension pneumocephalus. Method The retrospective analysis of the 12 patients with tension pneumocephalus who underwent surgical management was performed. Results Three patients underwent emergent burr hole drainage, and the remaining 9 underwent craniectomy drainage combined hematoma aspiration or surgical repair of the fistulas. All of the patients recovered successfully and the pneumocephalus disappeared during 2 to 4 weeks after operation without recurrence of the clinical symptoms. Conclusion It is possible that the patients with traumatic brain injuries accompany a complication of tension pneumocephalus, especially those also together with basilar or frontal skull fracture. The timely examination of X - ray, CT, and MRI can be helpful for the diagnosis and surgical treatment. An emergent or selective operation should be performed to manage this disease based on the patients＇ pathogenic conditions after the final diagnosis.

关 键 词：外伤性张力性气颅 手术治疗 临床诊断 发病机制 

分 类 号：R651.1[医药卫生—外科学]