脑出血外科治疗脑水肿变化与CT动态观察分析

目的探讨CT动态观察在脑出血手术治疗中对脑血肿、脑水肿及预后的评估价值。方法对我科136例脑出血患者于入院当天行头颅CT检查,观察出血量、出血部位及占位效应,并于术后第2天及第7天复查头颅CT,动态观察手术前后出血量与脑水肿变化。结果术前CT显示血肿越大,血肿灶周围水肿体积增大越明显,占位效应及中线移位越显著。术后血肿完全清除或大部分清除者,占位效应消失或明显好转。血肿部分清除或较术前加大者,脑水肿和占位效应也加重。结论 CT不仅能显示血肿部位、出血量、是否破入脑室及脑移位情况,并能动态观察手术前后脑血肿及脑水肿演变过程,为临床制定手术方案、观察疗效及估测预后提供直接依据。

Analysis of cerebral hemorrhage surgical treatment hydro-cephalus change and CT dynamic observation

Objective To study the discussion head CT treats at cerebral hemorrhage surgery to the brain haematoma,the hydro-cephalus and the prognosis appraisal value.Methods To 136 example cerebral hemorrhage patients in hospital at the same day the good head CT inspection,the observation hemorrhage quantity,the hemorrhage spot and occupies the position effect,and after the technique 2nd day and 7th day reexamination head CT,around the dynamic observation surgery bleeds the quantity and the hydro-cephalus change.Results In front of the technique the CT demonstration haematoma was bigger,around the haematoma stove dropsy volume increases obviously,occupies the position effect and median line shifting was more remarkable.After the technique the haematoma eliminates or the majority of elimination completely,occupies position effect vanishing or the obvious change for the better.The haematoma part eliminates or compares in front of the technique the enlarge,the hydro-cephalus and occupies the position effect also to aggravate.Conclusion Not only CT can demonstrate haematoma spot,hemorrhage quantity,whether broken enters the ventricles of the brain and the brain shifting situation,and can in front of the dynamic observation surgery the cerebellum haematoma and the hydro-cephalus successional variation process,for the clinical formulation surgery plan,the observation curative effect and the estimation prognosis provides the direct basis.