重型颅脑损伤术中急性脑膨出的处理

目的：探讨重型颅脑损伤患者术中急性脑膨出的术中处理方法和预防措施。方法：对76例术中发生急性脑膨出的重型颅脑损伤患者，分析术中处理方法及其与患者预后的关系。结果：术中除采用控制性降低收缩压、20％甘露醇加地塞米松快速静滴等措施外．采取适度的过度通气、迅速扩大骨窗等措施可降低患者死亡率，盲目探查对侧可致增加死亡率。结论：重型颅脑损伤患者术中急性脑膨出应采取过度通气、迅速扩大骨窗等综合措施，不宜盲目探查对侧。

The Treatments of Acute Intraoperative Encephalocele in Severe Craniocerebral Trauma

Objective:To discuss the treatment and prevention of acute intraoperative encephalocele in severe craniocerebral trauma. Methods: To study 76 cases of acute intraoperative encephalocele in severe craniocerebral trauma in order to find out the relationship between the treatment and prognosis. Results: Besides controlling decrease systolic pressure and 20% Mannitol with Dexamethasone infusion, proper excessive ventilation and enlarging the windows of the bone quickly can declinedly the mortality. Exploring oposite blindly can increase the mortality. Conclusion: Proper excessive ventilation and enlarging the windows of the bone quickly were effective in treating acute intraoperative encephalocele in severe craniocerebral trauma and it is not suitable to explore the opposite side blindly.