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目的分析重型颅脑损伤手术中急性脑膨出的临床特点及防治措施。方法对43例脑损伤患者术中出现脑膨出病情进行回顾性分析,总结其原因及防治措施。结果重型颅脑损伤术中急性膨出的危险因素有广泛脑挫伤导致急性弥漫性脑肿胀、颅内继发性血肿、严重脑疝、外侧裂损伤、脑组织缺血再灌注损伤等,积极采取措施预防脑膨出,术前正确急救、及时清除颅内血肿和去骨瓣减压手术,术中使用甘露醇脱水,适当控制血压,以及必要时行双侧去骨瓣减压术,可有效缓解颅内压增高。结论对于重型颅脑损伤手术中急性脑膨出采取多种措施,缓解脑膨出,可提高疗效。
Objective To analyze the clinical features and preventive measures of acute encephalocele during severe craniocerebral injury. Methods A retrospective analysis was made on the occurrence of encephalocele in 43 patients with brain injury. The causes and preventive measures were summarized. Results The main risk factors of acute bulging during severe craniocerebral injury were extensive brain contusion, acute diffuse brain swelling, secondary intracranial hematoma, severe hernia, lateral laceration injury, ischemia-reperfusion injury in brain tissue, etc. Measures to prevent encephalocele, preoperative correct first aid, timely removal of intracranial hematoma and debridement decompression surgery, the use of mannitol during dehydration, proper blood pressure control, and if necessary, bilateral decompressive craniectomy can be effective Relieve increased intracranial pressure. Conclusion Acute encephalocele in severe craniocerebral injury surgery to take a variety of measures to ease the encephalocele, can improve the curative effect.