急性脑肿胀去大骨瓣减压术后迟发性血肿

目的探讨外伤后急性脑肿胀去大骨瓣减压术后迟发性血肿的发病机制及临床表现，以提高该类病人的手术疗效。方法回顾性分析28例急性脑肿胀去大骨瓣减压术后迟发性颅内血肿病人的临床表现。结果外伤后急性脑肿胀去大骨瓣术后迟发性血肿的发生率为19．56％，术区继发硬膜外血肿10．87％。死亡率为32．12％。结论急性脑肿胀去大骨瓣术后迟发性血肿的发生率较高，多见于脑肿胀缓解病例，对术中出现的急性脑膨出和术后病情恶化应考虑到迟发性血肿的可能，早期的诊断是提高疗效的关键。

Delayed intracranial hematoma after decompressive teratment with standard large craniotomy in acute brain swelling

Objective To increase the operative effectiveness of standard large craniotomy on patients with traumatic acute brain swelling by investigating the pathological mechanism and clinical appearances of postoperative delayed intracranial hematoma.Methods A retropective study on the clincal appearances of delayed intracranial hematoma after standrad large craniotomy in traumatic acute brain swelling in 28 patients.Results The occurrence rate of delayed intracranial hematoma after standard large craniotomy in traumatic acute cerabral swelling was 19.56% and that of extradural haematomas in the operative area was 10.87%,the mortality was 32.12%.Conclusions Delayed intracranial hematoma is common in cases treated with large craniotomy,especially in alleviated patients with cerabral swelling.Acute intraoperative encephalocele and postoperative deterirating conditions suggest the possibility of delayed intracranial hematoma.Early diagnosis is the key to improve the porgnosis.