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目的探讨颅脑肿瘤患者开颅术后超早期CT检查的意义以及手术后出血的原因分析。方法回顾性分析我院2013年1月至2013年12月216例颅脑肿瘤手术后早期施行CT检查的患者资料。结果 216例颅内肿瘤开颅术后进行早期CT检查,9例术后发生颅内血肿,其中4例在术后超早期(6h内)行CT检查即有出血表现。该9例术后出血病患的病理分别为脑膜瘤5例,髓母细胞瘤1例,垂体腺瘤1例,转移瘤(鳞癌)1例,少突胶质瘤1例。该9例患者中,3例患者予以保守治疗,6例经再次手术清除颅内血肿。9例患者均好转。结论术中止血不彻底、术中颅内压骤降、富血管的肿瘤病理类型(如脑膜瘤)等是颅脑肿瘤患者术后形成血肿的可能原因。术后超早期CT检查可早期发现颅脑肿瘤术后出血,提高患者预后,对其临床意义值得深入研究。
Objective To explore the significance of ultra-early CT examination of craniocerebral tumor patients after craniotomy and the analysis of the causes of postoperative bleeding. Methods A retrospective analysis of our hospital from January 2013 to December 2013 216 cases of brain tumor surgery after the early implementation of CT examination of the patient data. Results 216 cases of intracranial tumors after craniotomy for early CT examination, 9 cases of intracranial hematoma occurred, of which 4 cases in the early postoperative (within 6h) CT examination showed hemorrhage. The pathology of the 9 cases of postoperative bleeding were meningioma in 5 cases, medulloblastoma in 1 case, pituitary adenoma in 1 case, metastasis (squamous cell carcinoma) in 1 case, oligodendroglioma in 1 case. Of the 9 patients, 3 were treated conservatively, and 6 underwent reoperation to remove the intracranial hematoma. All 9 patients improved. Conclusions The intraoperative hemostasis is not complete, the intracranial pressure drops suddenly, and the type of vascular pathology (such as meningioma) is the possible cause of hematoma in the patients with brain tumor. Ultra-early postoperative CT examination can be early detection of postoperative brain tumor hemorrhage, improve patient prognosis, its clinical significance deserves further study.