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重型颅脑损伤术中急性脑膨出原因及防治(附89例报告)
引用本文:董吉荣,江基尧,朱诚.重型颅脑损伤术中急性脑膨出原因及防治(附89例报告)[J].中华神经外科杂志,1999,15(1):4-6.
作者姓名:董吉荣  江基尧  朱诚
作者单位:第二军医大学附属长征医院神经外科,无锡解放军第一○一医院神经外科
摘    要:目的:探讨颅脑损伤手术中急性脑膨出的形成原因及有效的防治措施。方法对手术中出现脑膨出的89例颅脑损伤病人进行回顾性分析,总结其形成原因及易发征象,比较各种防治措施的疗效。结果术中迟发性颅内血肿的形成、急性弥漫性脑肿胀、脑组织缺氧和低血压、长时间脑疝、严重脑挫裂伤等是颅脑损伤术中急性脑膨出的主要原因,彻底清除颅内血肿、缓慢降低颅内压、术中过度通气、使用脱水剂、适当控制血压等是防治术中脑膨出的有效措施。结论针对不同病因采取相应措施可防治颅脑损伤术中脑膨出,取得较好疗效。

关 键 词:重型颅脑损伤  开颅手术  脑膨出

The causes and treatment of acute intraoperative encephalocele in severe head injured patients. (A report of 89 cases)
DONG Jirong,JIANG Jiyao,ZHU Cheng,et al..The causes and treatment of acute intraoperative encephalocele in severe head injured patients. (A report of 89 cases)[J].Chinese Journal of Neurosurgery,1999,15(1):4-6.
Authors:DONG Jirong  JIANG Jiyao  ZHU Cheng  
Institution:DONG Jirong,JIANG Jiyao,ZHU Cheng,et al. Department of Neurosurgery,Changzheng Hospiatal,Second Millitary Medical University,Shanghai 200003
Abstract:Objective: To summarize the causes and prophylactic therapeutic methods of acute intraoperative encephalocele in severe head injured patient. Methods Eighty nine severe head injured patients with acute intraoperative encephalocele were analysed retrospectively and the preventive and treating methods were implemented. Results Delayed intracranial heamatomas, acute diffuse brain swelling, cerebral anoxia, long term brain herniation and massive brain contussion and larceration were the main causes of intraoperative encephalocele. The methods of treatment should be removes heamatomas completely, decreasing intracranial pressure gradually, intraoperative hyperventilation, large dose of mannitol and maintain of systolic blood pressure respectively. Conclusion According to different causes the acute intraoperative encephalocele in head injured patients could be prevented and treated effectively.
Keywords:Severe traumatic head injury  Craniotomy  Encephalocele
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