摘要
目的 探讨重型颅脑创伤开颅术中急性脑膨出的形成原因及防治措施。方法回顾性分析56例重型颅脑创伤开颅术中出现急性脑膨出患者的临床资料。结果术中迟发性颅内血肿的形成、急性弥漫性脑肿胀、脑缺血缺氧、严重脑挫裂伤等是开颅术中急性脑膨出的主要原因。术中过度通气、彻底清除颅内血肿及挫伤坏死的脑组织以缓慢降低颅内压，是防治术中脑膨出的有效措施。本组死亡25例（45％），存活者于术后6个月根据GOS评分标准进行预后评估，其中良好8例（14％），中残10例（18％），重残11例（19％），植物生存2例（4％）。结论针对不同病因采取相应措施，可有效防治开颅术中急性脑膨出，提高治疗效果、改善患者预后。
Objective To explore the causes and prophylactic therapeutic interventions of acute intraoperative encephalocele in severe traumatic brain injury. Methods The clinical data of acute intraoperative encephalocele in fifty - six patients with severe traumatic brain injury were analyzed retrospectively. Results Delayed intracranial hematomas, acute diffuse brain swelling, cerebral anoxia and massive brain contusion and laceration were the main causes of intraoperative encephalocele. Intraoperative hyperventilation, complete removal of hematomas to decrease intracranial pressure gradually should be the methods for treatment. Twenty -five patients were died （45%）. The prognosis of the survivors were evaluated according to Glasgow Outcome Scale （GOS） at 8 months after operation, 6 cases of patients showed a good outcome （ 14% ）, 10 moderately disabled （ 18% ）, 11 severely disabled （ 19% ）, 2 permanent vegetative state （4%）. Conclusions Treatment exerted according to different causes could improve the effects and the prognosis of acute intraoperative encephalocele patients with severe traumatic brain injury.
出处
《中华神经外科杂志》
CSCD
北大核心
2014年第3期242-244,共3页
Chinese Journal of Neurosurgery
关键词
重型颅脑创伤
开颅术
急性脑膨出
Severe traumatic brain injury
Craniotomy
Acute encephalocele
