论文部分内容阅读
目的分析重型颅脑损伤患者术中急性脑膨出的原因和救治方法。方法对2003年12月-2008年8月13例术中出现急性脑膨出的重型颅脑损伤患者进行回顾性分析。结果术侧脑内血肿3例,对侧骨折局部硬膜外血肿5例,脑内血肿1例,术侧骨窗周围硬膜外血肿1例,弥漫性脑肿胀1例,另2例未行CT复查原因不清。死亡4例,伤后半年GOS评估,植物生存1例,重残2例,中残1例,良好5例。结论术中出现脑膨出时,首先考虑术侧脑内血肿、对侧骨折局部硬膜外血肿,再考虑对侧脑内血肿、术侧骨窗周围硬膜外血肿、弥漫性脑肿胀等。按顺序探查,必要时复查CT明确诊断给予及时、有效处理是救治术中急性脑膨出的重点。
Objective To analyze the causes and treatment of acute intracerebral encephalocele in patients with severe craniocerebral injury. Methods A retrospective analysis was performed on 13 cases of severe brain injury with acute encephalocele during operation from December 2003 to August 2008. Results The intracerebral hematoma in 3 cases, the contralateral fracture in 5 cases of local epidural hematoma, intracerebral hematoma in 1 case, 1 case of epidural hematoma around the surgical window, diffuse brain swelling in 1 case, the other 2 cases did not CT review the reasons are not clear. 4 died, 6 months after injury GOS assessment, plant survival in 1 case, severe disability in 2 cases, 1 case of disability, good in 5 cases. Conclusion Intraoperative brain bulge, the first consideration of intraoperative intracerebral hematoma, contralateral fracture of the local epidural hematoma, and then consider the contralateral intracerebral hematoma, epidural hematoma around the lateral bone window, diffuse brain swelling and so on. In order to explore, if necessary, review the CT diagnosis given timely and effective treatment is the focus of treatment of acute encephalocele.