脑肿瘤手术后血肿--近10年病例分析

目的 减少颅脑肿瘤手术后血肿的发生,改善患者预后。方法 分析自1991年7月～2001年6月发生的脑肿瘤手术后颅内血肿12例,包括血肿发生率、血肿部位与出现时间、相关因素及预防处理等。结果 术后血肿出现的高峰时间在8h内,血肿好发部位为额顶硬膜外。远隔部位术后血肿的发生与过分急骤颅压改变有关;手术野血肿与止血是否恰当、引流管放置及颅脑各层结构的完整性有关。术后血肿的发生与肿瘤病理性质、部位无关,与患者的脑血管状况有关。结论 术后8h内强化监护并及时处理血肿对改善患者预后至关重要。

Postoperative intracraniai hematoma in resection of brain tumor (experiences in recent ten years)

Objective For reducing the incidence of postoperative intracranial hematoma after resection of brain tumor and improving patients prognosis the cases were studied. Methods The postoperative hematomas with brain tumor of 12 patients in this hospital during July 1991-June 2001 were analyzed. The data were including incidence, sites and onset time of postoperative intracranial hematoma, its related factors and preventive management. Results The peak incidence was occurred within 8 hours postoperation. The most common sites of hematoma were frontoparietal epidural. The occurrence of remote site postoperative hematoma was correlated with rapid change of intracranial pressure. The hematoma in operation field was occurred relating with inappropriate hemostasis and drainage, and integrity of cranial structures in various levels. The occurrence of postoperative hematoma was not correlated with the property and site of tumor but correlated with the cerebral vascular condition. Conclusion The postoperative intensive care within 8 hours and immediate managing of hematoma are most important for improving the patients' outcome.