外伤性张力性气颅的诊断和治疗

目的:探讨外伤性张力性气颅的诊断和治疗方法,提高临床治疗水平.方法:按发病急缓、积气部位以及是否合并颅内严重损伤将患者分为三组,并依此分别采用保守治疗(9例)、钻孔引流(8例)和开颅手术(8例)进行治疗.结果:保守组和引流组分别有8例和7例在3周内积气消失,另各有1例无效者在2周后中转鼻内镜颅底修补痊愈;开颅组8例经排空积气、清创并修复颅底缺损后治愈.无术后颅内感染、脑脊液漏、脑膜脑膨出及手术死亡等发生.结论:按发病急缓、积气部位以及是否合并颅内严重损伤来对外伤性张力性气颅进行诊断和分组,并依此选择保守治疗、钻孔引流和开颅或鼻内镜手术进行治疗能获得良好治疗结果.

The Diagnosis and Treatment of the Post-traumatic Tension Pneumocephalus

Objective: To study the diagnosis and treatment methods of the traumatic tension pneumocephalus. Methods: Depending on individual patients condition, 25 cases were treated by conservative in 9, drill a hole to drainage in 8 and surgery to repair skull-base defect in 8. Results: After two weeks, The tension pneumocephalus were disappearance 8 in conservative treatment group, 7 in drainage group and all of in surgery group, the other 2 cases were cured by nasal endoscope skull base repair, No operative death and serious complications (e.g. intracranial infection, CSF leakage or impulse exophthalmos) happen. Conclusions: Depending on the onset , location and whether or not combined with major brain injury to select conservasion,drainage and surgery or nasal endoscope skull base repair can gain well therapeutic effect.