颅脑损伤术中发生急性脑膨出的原因分析

目的探讨颅脑损伤术中脑膨出的原因。方法对2004年3月至2008年3月收治的37例颅脑损伤术中发生脑膨出患者的临床资料进行回顾性分析。结果本组病人术中发生急性脑膨出的原因包括迟发性颅内血肿（18例），广泛严重性脑挫裂伤、脑肿胀（8例），创伤后呼吸困难、创伤性休克和术中低血压导致脑组织缺血、缺氧（6例）及晚期脑疝、血肿压迫时间长（5例）。出院时按GOS评定预后：良好7例，中残6例，重残5例，植物生存2例，死亡17例。结论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，以取得较好疗效，降低患者死亡率。

Causes of Acute Encephalocele during Operation in Patients with craniocerebral Injury

Objective To explore the causes of intraoperative acute encephalocele in the patients with craniocerebral injury.Method The clinical data of 37 patients with eraniocerebral injury,who suffered from acute encephalocele during the operation from March,2004 to March,2008,were analyzed retrospectively.Results The cause of intraoperative acute encephalocele in 37 the patients with craniocerebml injury included delayed intraeranial hematomas(18 cases),extensive and severe brain contussion and brain swelling (8 cases),cerebral ischemia and hypoxia due to dyspnea,traumatic shock,and intraoperative hypotension(6 eases),and long-time pressure upon the brain by the late cerebral hemiation and hematoma(5 cases).According to Glasgow Outcome Score (GOS) on discharge from hospital,of 37 patients,7 were recovered well,6 moderately disabled,5 severely disabled,2 vegetatively survived,and 17 died.Conclusion Understanding the causes and active treatment of intraoperative acute eneephalocele can improve the prognosis and decrease the mortality in the patients with craniocerebral injury.