重型颅脑损伤术中急性脑膨出的临床分析及对策  

Analysis of Cause of Acute Intraoperative Encephalocele and Its Operation Treatment in Patients with Severel Head Injuries

作　　者：王建涛 徐秀敬 杨新生[2] 亓卫国[2] 于树伟 

机构地区：[1]山东省莱阳市中医医院神经外科,山东莱阳265200 [2]青岛大学医学院附属医院神经外科,山东青岛266003

出　　处：《实用临床医学（江西）》2008年第8期50-52,共3页Practical Clinical Medicine

摘　　要：目的探讨重型颅脑损伤开颅手术中急性脑膨出的形成原因及对策。方法回顾分析59例术中出现脑膨出的重型颅脑损伤患者的受伤机制、临床表现、CT特征,总结脑膨出形成原因。结果经治疗后6个月恢复良好13例,中残15例,重残8例,死亡23例。结论迟发性颅内血肿、急性脑肿胀、低血压、脑缺氧、长时间脑疝是重型颅脑损伤术中急性脑膨出的主要原因。正确判断脑膨出的性质,采取相应的术中对策是治疗术中脑膨出的有效措施。Objective To explore the cause of acute intraoperative encephaiocele and its operative methods in the patients with severel head injuries. Methods The injury mechanism, clinical manifestations and CT data of 59 patients with acute encephalocele during the surgery for severe head injuries were analyzed retrospectively. Results According to GOS, of 59 patients with acute intraoperative encephalocele, 13 were well recovered from their illness, 15 moderately disabled,8 severely disabled and 23 died at 6 months after the treatment. Conclusion The main cause of the acute intraoperative encephalocele included delayed intracranial heamatoma, acute brain swelling, hypotention, cerebral anoxia, long-term brain herniation in the patients with severel head injuries. The correctly diagnosis and operative treatment for intraoperative encephalocele can significantly reduce the mortality and disability.

关 键 词：颅脑损伤 脑膨出 颅内血肿 脑肿胀 开颅手术 

分 类 号：R651.15[医药卫生—外科学]