颅脑伤伤员开颅术中急性脑膨出的原因及处理

目的 探讨颅脑伤开颅术中脑膨出的原因、临床特点、早期诊断和治疗方法。方法 根据术中脑膨出的速度,脑组织的质地,术前受伤着力部位及头颅CT扫描结果,分析脑膨出的原因。结果 共治疗25例脑膨出,死亡11例,手术死亡率为44％。结论 对迟发血肿所致的脑膨出,术前应该意识到,并作好准备。术中尽力缩短对侧血肿压迫脑组织的时间;对血管麻痹所致的脑膨出,术前应预防缺氧,术中最大限度地进行减压,术后及时正确地行腰穿。以上措施可望改善预后。

The causes and treatment of acute encephalocele during craniotomy on head-injured patients

to uncover the causes,clinical features, early diagnosis and treatment of acute encephalocele during craniotomy on head-injured patients. Methods The causes of encephalocele were analyzed according to the expanding velocity and the character of the injured brain, the hit sites of the head and cranial CT scans. Results 25 cases of encephalocele were treated, 11 died, the mortality was 44%. Conclusion It should be awared to and prepare for the encephalocele caused by delayed hematoma before craniotomy. The time of brain oppression by contralateral hematoma should be shortened to the minimum during operationo As for the encephalocele due to vessel paralysis,the emphasis should be put on preventing anoxia before craniotomy, decompression must be sufficiento Lumbar puncture promptly and correctly after craniotomy would be helpful to improve the prognosis.