术中窦汇区迟发性硬膜外血肿致急性脑膨出的治疗  

The treatment of malignant encephalocele caused by acute epidural hematoma around confluens sinuum in operation

作　　者：徐勤义[1] 董吉荣[1] 蔡学见[1] 王玉海[1] 刘斌[1] 时忠华[1] 金东[1] 冯毅[1] 何建青[1] 

机构地区：[1]解放军第一0一医院神经外科,全军颅脑创伤中心,无锡214044

出　　处：《中华神经外科杂志》2010年第6期520-522,共3页Chinese Journal of Neurosurgery

摘　　要：目的 探讨颅脑损伤患者术中窦汇区迟发性硬膜外血肿所致急性脑膨出的临床特点及诊治经验.方法 回顾我院2007年5月至2009年5月收治的10例颅脑损伤患者,均为开颅术中发现急性脑膨出,术中复查头颅CT明确窦汇区迟发性硬膜外血肿的诊断后,取顶枕部＂U＂形切口,做窦汇区骨瓣成形加自体筋膜加压修补术.结果 根据GOS评分判断愈后：中残2例,重残1例,植物生存1例,死亡6例.结论 窦汇区硬膜外血肿做跨窦骨瓣成形术,骨瓣足够大,出血点完全暴露,再用自体筋膜加压修补术彻底止血,是理想的手术方法 .早期诊断及正确的手术方法 是救治成功的关键.Objective To investigate the characteristics of malignant encephalocele caused by acute epidural hematoma around confluens sinuum during operation. Method Ten patients admitted from May 2007 to May 2009 in our hospital was reviewed. All cases presented malignant encephalocele during operation and acute epidural hematoma around confluens sinuum after CT scan. We made craniotomy with a bone flap under U - shape incision and self - fascia was used to patch compressively for hemostasis. Results According to the GOS score 2 cases had satisfactory outcome with moderately disability, 1 severe disability, 1 vegetative state, 6 dead.Conclusion Patients with acute epidural hematoma around confluens sinuum might be made craniotomy in a big enough bone - flap so that bleeding point exposed wholly and stopped bleeding by self - fascia patch repair compressively. Early diagnosis and correct operative technique might be key point for successful remedy.

关 键 词：颅脑损伤 颅内硬膜外血肿 脑膨出 外科手术 

分 类 号：R651.15[医药卫生—外科学]