重型颅脑损伤术中急性脑膨出治疗体会

目的探讨影响重型颅脑损伤开颅术中急性脑膨出的原因及有效防止措施。方法回顾分析我院2009-01—2010-12收治的12例重型颅脑损伤术中急性脑膨出采取新处理方法的病例资料作为研究组,同时选择2007-01—2008-12收治的9例重型颅脑损伤术中急性脑膨出病例资料作为对照组,分析2组的疗效。结果研究组恢复较好5例,重残5例,死亡2例;对照组恢复较好1例,重残3例,死亡5例。2组比较差异有统计学意义(P<0.05)。结论重型颅脑损伤术中发生急性脑膨出,要排除迟发颅内血肿后采取控制降压、过度换气、脑室引流、切除颞叶脑组织等综合措施,能够明显提高治疗效果,降低致残率和病死率。

Treatment of acute encephalocele in severe traumatic brain injury patients

Objective To investigate the causes and effective prevention measures of acute encephalocele with severe traumatic brain injury in craniotomy.Methods From January 2009 to December 2010,12 cases of acute encephalocele of severe traumatic brain injury admitted in craniotomy of our hospital were retrospective analyzed,these patients were taken a new approach,the clinical data of these groups as research group,and the data of 9 patients of acute encephalocele of severe traumatic brain injury admitted in craniotomy as control group from January 2007 to December 2008.The data of two groups were analyzed.Results The study group recovered well than control group,5 cases recovered well,5 cases with severe disability and 2 cases died;one case restored good,3 cases with severe disability and 5 cases died in the control group.The difference was significant(P<0.05).Conclusion After excluding the delayed intracranial hematoma,if happened the acute encephalocele of severe traumatic brain injury patients in craniotomy,some comprehensive measures must be taken,such as controlling blood pressure,hyperventilation,ventricular drainage,the removal of the temporal lobe brain tissue,can significantly improve the therapeutic effect,and reduce the induced residual morbidity and mortality.