术中非手术区迟发性颅内血肿致急性脑膨出的高危因素及抢救体会40例  

The high risk factors and emergency treatments to the patients with intraoperative acute encephalocele caused by delayed intracranial hematomas at non operating region:An investigate of 40 cases

作　　者：赵刚[1] 刘帅[1] 李俊[1] 王宇[1] 孙继程 张义[1] 王铂[1] 

机构地区：[1]铁法煤业集团总医院神经外一科,辽宁调兵山112700

出　　处：《中国现代医生》2014年第23期145-148,共4页China Modern Doctor

摘　　要：目的探讨术中非手术区迟发性颅内血肿致急性脑膨出患者的临床高危因素及抢救经验。方法对2000年1月～2013年12月40例术中非手术区迟发性颅内血肿致急性脑膨出患者的临床资料进行回顾性分析。总结其高危因素及抢救经验。结果对冲伤22例。术前合并广泛脑挫裂伤14例，合并颅骨骨折16例，合并颅内小血肿（〈15mL）10例。致急性脑膨出的颅内血肿中对侧32例，其中硬膜外血肿24例。再手术32例，存活16例，总死亡率60％。结论术中非手术区迟发性颅内血肿致急性脑膨出高危因素为广泛脑挫裂伤、对侧颅骨骨折、非手术区的颅内小血肿。掌握其临床高危因素，有足够的预见性，充分的术前准备，正确的术中处理。术后科学系统的综合治疗才能最大限度地挽救患者生命。Objective To investigate the high risk factors and emergency treatments to the patients with intraoperative acute encephalocele caused by delayed intracranial hematomas at non operating region. Methods The clinical data of 40 patients with intraoperative acute encephalocele caused by delayed intracranial hematomas at non operating region from January 2000 to December 2013 were analyzed retrospectively. Summarized the high risk factors and emergency treatments in this case. Results The 22 cases with contrecoup injury. 14 cases with extensive contusion of brain,16 cases with skull fracture and 10 cases with small intracranial hematoma （Volume 〈15mL）.The delayed intraeranial hematomas to the acute encephalocele include, 32 cases at the offside. And 24 cases with epidural hematoma. 32 cases had to undergo reoperation, survived 16 cases. The total death rate was 60%. Conclusion The high risk factors are extensive contusion of brain, offside skull fracture and the delayed intraeranial hematomas at non operating region. Understanding Its high risk factors in clinical, with much more foreseeability, and sufficient preoperative preparation, right intraoperative treatment, a scientific system comprehensive treatment postoperation can save the patients＇ life in maximum.

关 键 词：非手术区 迟发性颅内血肿 脑膨出 

分 类 号：R651.15[医药卫生—外科学]