高压电击伤致头皮缺损及脑脓肿1例  

Scalp defect and brain abscess caused by high voltage electric injury:a case report

作　　者：尚银武 王飞 刘建雄[1] 金明 SHANG Yinwu;WANG Fei;LIU Jianxiong;JIN Ming(Department of Neurosurgery,Gansu Provincial People's Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院神经外科,兰州730000

出　　处：《中国神经精神疾病杂志》2022年第2期105-108,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：总结高压电击伤致头皮缺损并发脑脓肿的治疗方法。1例51岁女性患者,因“高压电致头皮缺损、双上肢及右下肢灼伤约12 h”就诊,可见顶枕部皮肤及全身多处皮肤烧伤,行颅脑CT提示开放型颅脑重型损伤。入院后头部创面可见焦炭样颅骨外露,复查颅脑CT示:左侧枕颞叶见大片高低密度影,左侧侧脑室受压。给予脱水降颅压及皮瓣移植手术,后颅脑水肿较前减轻,复查颅脑核磁示颅骨缺损处硬膜下脓肿。行坏死颅骨切除术+硬膜下脓肿切除术+皮瓣移植术,术后给予腰大池引流及抗感染治疗,经治疗后患者好转出院。高压电击伤致头皮缺损颅内损伤严重,后期易形成脑脓肿,应早期行手术治疗,并给予脱水降颅压及抗感染治疗。To summarize the treatment of scalp defect complicated with brain abscess caused by high voltage electric injury.A 51-year old female patient complained about"scalp defect caused by high voltage electricity and burns of both upper limbs and right lower limbs for about 12 hours".Multiple skin burns of the top and occipital skin and the whole body were seen.Craniocerebral CT showed open severe craniocerebral injury.After admission,the coke like skull was exposed on the head wound.The re-examination of brain CT showed that there were large high and low density shadows in the left occipitotemporal lobe,and the left lateral ventricle was compressed.The dehydration and cranial pressure reduction and skin flap transplantation were given.The postoperative brain edema was reduced after treatment.The re-examination of brain MRI showed the subdural abscess at the skull defect,necrotic skull resection+subdural abscess resection+skin flap transplantation were performed,and lumbar cistern drainage and anti-infection treatment were given after the operation,After treatment,the patient was discharged after improvement.Scalp defect and intracranial injury caused by high voltage electric injury are serious,and brain abscess is easy to form in the later stage.Surgical treatment should be carried out in the early stage,and dehydration,intracranial pressure reduction and anti-infection treatment should be given.

关 键 词：电击伤 头皮缺损 脑脓肿 颅脑损伤 皮瓣移植术 脑水肿 

分 类 号：R651[医药卫生—外科学]