重型颅脑损伤去骨瓣减压术后颞肌肿胀致颅内压增高的治疗  

Management of increased intracranial pressure caused by temporal muscle swelling after decompressive craniectomy in patients with sereve traumatic brain injury

作　　者：秦华平[1] 官卫[1] 杨常春[1] 马涛[1] 施益民[1] 周建军[1] 杨伊林[1] 

机构地区：[1]苏州大学附属第三医院神经外科,常州213003

出　　处：《中华神经医学杂志》2015年第9期955-957,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨重型颅脑损伤去骨瓣减压术后颞肌肿胀致颅内高压的诊断和治疗。方法回顾性分析苏州大学附属第三医院神经外科自2004年1月至2012年1月收治的46例重型颅脑损伤去骨瓣减压术后颞肌肿胀致颅内高压患者的临床资料和疗效，其中保守治疗22例，手术治疗24例。结果46例患者病情恢复均满意，GOS预后评分评估为恢复良好23例、中残12例、重残8例、植物生存3例。无死亡病例。结论重型颅脑损伤去骨瓣减压术后颞肌肿胀可导致二次颅内压增高，严重影响患者预后，故应积极预防、及时处理。Objective To exptore the diagnosis and treatment of increased mtracramal pressure caused by temporal muscle swelling after decompressive craniectomy in patients with severe traumatic brain injury. Methods A retrospective analysis was performed on 46 patients with increased intracranial pressure caused by temporal muscle swelling after decompressive craniectomy, admitted to our hospital from January 2004 and January 2012. Among them, 22 were treated with conservative therapy, and the other 24 were treated with operative therapy. Results Based on Glascow Outcome Scale scores, 23 recovered well, 12 had moderate disability, 8 had severe disability, 3 were at vegetative state and no death was noted. Conclusions Temporal muscle swelling after decompressive craniectomy may cause secondary increased intracranial pressure, and this will lead a negative effect on recovery of patients with severe traumatic brain injury. Early prophylaxis, early diagnosis and early treatment are necessary for these patients.

关 键 词：颅脑损伤 去骨瓣减压术 颞肌肿胀 颅内高压 

分 类 号：R651.15[医药卫生—外科学]