重视去骨瓣减压术后脑积水的特殊性

Focusing on the particularity of hydrocephalus after decompressive craniectomy

在颅脑创伤的治疗中,去骨瓣减压术是非常重要的治疗手段,可以缓解颅内高压,挽救患者生命。因去骨瓣减压术改变了脑内的压力平衡,而颅内压(或者说脑室内压)是影响脑积水发生及其诊断的一个重要因素,因此对于去骨瓣减压术后脑积水的诊断和治疗不能类同于颅骨完整的脑积水的标准,有其特殊性。笔者通过对去骨瓣减压术后颅内压变化进行分析,在此基础上,总结这一类型脑积水在诊断、治疗及预防上的特殊性。

Decompressive craniectomy is a critical therapy choice to alleviate cranial hypertension after traumatic brain injury.The incidence of hydrocephalus after decompressive craniectomy could be higher in literatures.However,the pressure within the brain is changed after decompressive craniectomy.Moreover,intracranial pressure(or intraventricular pressure)is an important factor affecting the occurrence and diagnosis of hydrocephalus.Therefore,the diagnosis and treatment of hydrocephalus after decompressive craniectomy can not be the same to the common hydrocephalus without decompressive craniectomy.Here,we analyzed the occurrence of hydrocephalus after decompressive craniectomy,and summarized the particularities for its diagnosis and treatment.