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目的探讨急性颅脑损伤开颅术中脑膨出的原因及防治措施。方法回顾性分析我院近年来收治的78例颅脑损伤开颅术中出现急性脑膨出病例的临床资料,总结脑膨出的原因和防治经验。结果迟发性颅内血肿、弥漫性脑肿胀是颅脑损伤术中急性脑膨出的主要原因。78例术后6个月根据格拉斯哥预后评分(GOS)评定:恢复良好19例(其中16例为双侧开窗减压者),中残15例,重残17例,死亡27例,死亡率34.6%。结论分层次减压的方法对预防脑膨出有显著疗效。而术中急性脑膨出一旦发生,应查明原因并作出相应处理,能大大提高患者的预后效果,降低死亡率。
Objective To investigate the causes and preventive measures of brain bulge during craniotomy for acute craniocerebral injury. Methods A retrospective analysis of 78 cases of craniocerebral trauma craniotomy admitted to our hospital in recent years, the clinical data of cases of acute encephalocele, summarizes the causes of encephalocele and prevention and treatment experience. Results delayed intracranial hematoma, diffuse brain swelling is the main cause of acute brain edema during craniocerebral injury. 78 cases were evaluated according to the Glasgow Outcome Scale (GOS) at 6 months after operation: 19 cases were recovered well (16 cases were bilateral window decompression), 15 cases were moderate disability, 17 cases were severe disability, 27 cases died and the mortality 34.6%. Conclusion The method of stratified decompression has a significant effect on the prevention of encephalocele. The acute intracerebral encephalocele occurs, should identify the cause and make the appropriate treatment, can greatly improve the prognosis of patients, reduce mortality.