重型颅脑损伤术中急性脑膨出38例临床分析

目的探讨重型颅脑损伤术中急性脑膨出的主要原因、早期诊断与应急处治方法 ,以提高治愈率,降低致残率和死亡率。方法对38例重型颅脑损伤术中急性脑膨出的临床资料进行回顾性分析。结果死亡16例,占42.1%;植物生存2例,占5.3%;中残6例,占15.8%;重残4例,占10.5%;良好10例,占26.3%。结论颅内血肿、弥漫性脑肿胀、脑水肿是重型颅脑损伤术中急性脑膨出的主要原因。早期诊断、针对不同的原因迅速采取相应的应急处治措施及综合治疗是治疗脑膨出成功的关键。

Clinical Analysis of 38 Cases with Acute Encephalocele in the Operation of Severe Craniocerebral Injury

Objective To discuss the main causes,earlier diagnosis and emergent measurement of acute encephalocele in the opertation of severe craniocerebral injury so as to raise the curative rate and to decrease the deformity rate and mortality.Methods A retrospective analysis was made to the clinical data of the 38 cases with acute encephalocele in the operation of severe craniocerebral injury.Results Out of the 38 cases,death occurred in 16 cases （42.1%）,vegetative status in 2 cases （5.3%）,moderate deficits in 6 cases （15.8%）,severe deficits in 4 cases （10.5%） and good recoveries in 10 cases （26.3%）.Conclusions The main causes of encephalocele in the operation of severe craniocerebral injury include intracranial hematoma,diffuse brain swelling and brain edema;earlier diagnosis,emergent corresponding measurement and general therapy are the key for a successful treatment of encephalocele.