重型颅脑损伤术中急性脑膨出的原因及治疗方案探讨

目的 探讨颅脑损伤术中脑膨出的原因及治疗对策.方法 对颅脑损伤术中发生脑膨出患者55例的临床资料进行回顾性分析.结果 55例术中发生急性脑膨出的原因包括迟发性颅内血肿（28例）,广泛严重性脑挫裂伤、急性脑肿胀（19例）,晚期脑疝、血肿压迫时间过长、脑疝后脑梗死（4例）,创伤性休克和术中低血压导致脑组织缺血、缺氧（4例）.出院时按GOS评定预后：良好3例,中残5例,重残8例,植物生存5例,死亡34例.结论 迟发性颅内血肿、急性脑肿胀是术中急性脑膨出的主要原因.明确颅脑损伤术中发生急性脑膨出的原因,尽早采取相应措施,可降低患者病死率.

Investigation on the cause and treatmene strategies for patients with severe acute head injury causes encephalocele

Objective To investigate the causes and treatment strategies of intraoperative encephalocele brain injury.Meethods 55 traumatic brain injury patients with intraoperative encephalocele were selected,the clinical data were retrospectively analyzed.Results 55 patients undergoing acute encephalocele reasons including widespread severity of brain contusion,acute brain swelling（19cases）,delayed intracranial hematoma（28 cases）,the late herniation,hematoma too long（4 cases）,traumatic shock and hypotension leading to cerebral ischemia,hypoxia （4 cases）.Assessed by GOS outcome at discharge：Good 3 cases,moderate disability in 5 cases,8 cases of severe disability,vegetative five cases,of whom 34 died.Conclusion Delayed intracranial hematoma,acutebrain swelling is an acute intraoperative encephalocele main reason.Clear intraoperative brain injury causes acute encephalocele,take appropriate measures as soon as possible,in order to achieve better results and reduce mortality.