开颅术后并发非手术区急性血肿的探讨

报告开颅术后并发非术区急性血肿14例。其中硬膜外血肿9例，硬膜下血肿3例，脑内血肿2例。分析认为，术中颅内压力的骤降，水后脑蹋陷，为发生硬膜外、硬膜下血肿的主要原因。高龄、高血压、糖尿病患者，手术易并发脑内血肿。术中平缓降颅压，平稳的麻醉，术后严密监护，及时头颅CT扫描是预防和早期诊断此类血肿至关重要的环节。及时再次手术清除血肿是成功救治的关键。文中特别讨论了国产头颅固定架的缺陷及改进措施。

Acute intracranial hematomas on unoperated areas following cranial operations

14 Cases of acute intracranial hematomas on unoperated areas are reported. Among them, 9 cases were extradural hematomas, 3 cases were subdural hematomas, 2 cases were intracerebal hematomas. The main causes of complicating extradural, subdural hematomas were: intracranial pressure went down too faster during operation, intracranial cavity was too more after operation. Olds, hypertensions, diabetes complicated intracerebal hematomas easily. Authors suggest: intracranial pressure down slowly, aIlesthesia smoothly, ICU and CT scaning were important works on preventing and treating these complications. In this article, we pointed out the fault on the self-made Mayfield-Kees 3-pin head holder,and adviced the improve motions.