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目的:探讨重型颅脑创伤术中,急性脑膨出的原因及应对方法。方法:收集2000~2008年本院神经外科住院的重型颅脑创伤术中出现急性脑膨出的患者29例,分析其发生原因、疗效、预防方法。结果:29例患者中,死亡15例(15/29,51.72%),其中,弥漫性脑肿胀10例,死亡6例;迟发性颅内血肿8例,死亡2例,术后6个月GOS评分良好3例(37.5%),中残2例(25%);其他原因11例,死亡7例。结论:弥漫性脑肿胀和迟发性颅内血肿是术中急性脑膨出的最主要原因(18/29,62.06%),根据不同病因采取积极应对措施有利于提高临床疗效。
Objective: To investigate the causes and treatment of acute brain bulge in severe traumatic brain injury. Methods: A total of 29 patients with acute encephalocele in severe craniocerebral injury hospitalized from 2000 to 2008 in our department of neurosurgery were enrolled. The causes, curative effects and prevention methods were analyzed. Results: Of the 29 patients, 15 died (15/29, 51.72%), of which 10 were diffuse brain swelling and 6 died. Eight patients had delayed intracranial hematoma and 2 died. Six months after operation GOS score was good in 3 cases (37.5%), 2 cases of residual (25%); 11 cases of other reasons, 7 died. Conclusions: Diffuse brain swelling and delayed intracranial hematoma are the most important causes of acute intracerebral hemorrhage (18/29, 62.06%). Taking active measures according to different causes is helpful to improve clinical efficacy.