颅内肿瘤切除术后继发血肿分析及处理  

Secondary intracranial hematomas after microsurgery of brain tumor

作　　者：兰川[1] 吴南[1] 李飞[1] 陈志[1] 朱刚[1] 林江凯[1] 高伯元[1] 崔高宇[1] 孟辉[1] 冯华[1] 

机构地区：[1]第三军医大学西南医院神经外科,中国人民解放军神经系统疾病微创诊治专科中心,重庆400038

出　　处：《中华神经外科杂志》2009年第9期819-822,共4页Chinese Journal of Neurosurgery

基　　金：国家“十一五”科技支撑计划项目（2007DAI05D08）

摘　　要：目的总结颅内肿瘤术后继发血肿的病例，探讨防治对策。方法回顾性分析手术切除颅内肿瘤后继发血肿的临床资料。结果702例颅内肿瘤病人术后19例（2．71％）继发颅内血肿；均发生于术后48h内，16例发生于24h内；12例病例出现脑疝或脑疝前期症状，7例为术后CT检查发现；继发血肿病例术中失血量平均为1102．63ml；5例曾行脑室外引流；再次手术血肿清除后痊愈12例，部分神经功能障碍4例，植物生存1例，死亡2例。结论术前、术中对患者危险因素的充分评估以及术后的密切监测是减少继发血肿的前提，治疗的关键在于早期发现、早期行血肿清除。Objective To analyze the features and risk factors of secondary intracranial hematomas after microsurgery of intracranial tumors. Method The clinical records of the patients with secondary intracranial hematomas after brain tumor surgery were analyzed retrospectively. Results 19 out of 702 patients with brain tumor resection were suffered from secondary intraeranial hematomas, all of which were found in 48 hours,and 16 were found in 24 hours. 12 cases with signs of heniation and others were found by regular CT scan. The patients had average blood loss of 1102. 63 ml and external ventricular drainage were performed during surgery in 5 cases. Hematomas were eliminated in all of the 19 cases, and the outcomes of 12 patients were good, but there were also 4 cases with functional impairments, one in persistent vegetative state, and two death. Conclusions It is important for thoroughly evaluations of the risk factors to decrease the secondary intracranial hematomas, and the key points of the management for patients with secondary intracranial hematomas should be early detection and treatment.

关 键 词：血肿 脑肿瘤 显微外科手术 

分 类 号：R686[医药卫生—骨科学]