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重型颅脑损伤开颅术中急性脑膨出临床分析
引用本文:周强,周岱,杨伊林,王之敏,王穗暖,夏锡伟,宣井岗,彭亚,邵耐远.重型颅脑损伤开颅术中急性脑膨出临床分析[J].中国现代医药杂志,2005,7(4):12-14.
作者姓名:周强  周岱  杨伊林  王之敏  王穗暖  夏锡伟  宣井岗  彭亚  邵耐远
作者单位:1. 215006,苏州大学附属第一医院脑外科
2. 苏州大学附属第三医院,常州第一人民医院脑外科
摘    要:目的探讨重型颅脑损伤开颅术中急性脑膨出的原因及有效防治措施。方法回顾性分析35例重型颅脑损伤开颅术中出现脑膨出的原因及防治措施的疗效。结果急性脑肿胀、术中迟发性颅内血肿形成、严重脑挫裂伤、长时间脑组织缺血缺氧是重型颅脑损伤开颅术中并发急性脑膨出的主要原因,本组病例死亡20例,占57.1%,存活15例,占42.9%。结论彻底清除颅内血肿,充分减压,缓慢降低颅内压,控制血压,改善脑部缺血缺氧是预防及治疗术中脑膨出的有效措施。

关 键 词:重型颅脑损伤  开颅术  急性脑膨出
修稿时间:2005年3月27日

Clinical analysis for acute encephalocele during severe traumatic cerebral operatoin
Zhou Qiang,Zhou Dai,Yang Yilin,et al..Clinical analysis for acute encephalocele during severe traumatic cerebral operatoin[J].Modern Medicine Journal of China,2005,7(4):12-14.
Authors:Zhou Qiang  Zhou Dai  Yang Yilin  
Institution:Zhou Qiang,Zhou Dai,Yang Yilin,et al. Department of Neurosurgery,The First Affiliated Hospital of Suzhou University,Suzhou 215006
Abstract:Objective To discuss the reasons for and prophylactic therapeutic methods of acute encephalocele during severe traumatic cerebral operatoin. Methods Thirty- five severe head injured patients with acute intraoperative encephalocele were analysed retrospectively and the preventive and treating methods were implemented. Results Acute brain swelling, de- layed intracranial hematomas during operation, severe brain contussion and larceration and long- term cerebral anoxia were the main reasons for acute encephalocele during severe traumatic cerebral operatoin. Conclusion Complete hematoma evacuation, sufficient decompression, decreasing intracranial pressure gradually, maintain of systolic blood pressure and improvement of cerebral anoxia are effective methods for prevention and treatment of acute intraoperative encephalocele.
Keywords:Severe traumatic head injury Craniectomy Acute encephalocele
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