颅内肿瘤开颅术后再出血的原因及其防治

Causes of intracranial hematoma after craniotomy in patients with intracranial tumors and its measures of prevention and treatment

目的探讨颅内肿瘤患者开颅术后再出血的原因及其防治措施。方法回顾性分析20例颅内肿瘤患者开颅术后发生颅内血肿的临床资料,总结其形成的原因。结果在20例术后发生颅内血肿的患者中,14例血肿位于原手术区,6例位于非手术区。所有病例均经再次手术清除颅内血肿。再次手术后,12例痊愈,3例残废,5例死亡。结论术中颅内压骤降、止血不彻底、操作性损伤及术后再灌注损伤等是颅内肿瘤患者开颅术后发生颅内血肿的主要原因。术前、术中采取相应的措施,术后严密监护,早期诊断是防治术后颅内血肿的关键。

s: To explore the causes of intracranial hematoma after craniotomy in the patients with intracranial tumors and its measures of prevention and treatment. The clinical data of twenty patients with cranial tumors who had undergone intracranial hematoma after craniotomy were analyzed retrospectively,and the causes were summarized. The cranial hematoma located in the operative area in 14 patients and 6 in the other area. All patients were received the second operation for clearing away the intracranial hematoma. After the second operation, 12 cases were recovered fully, 3 disabled, and other 5 died. [Conclusions] Quickly dropping of intracranial pressure, not downright hemostasia and brain tissue damage during the operation and reperfusion injury after operation are the essential causes of intracranial hematoma after craniotomy in the patients with intracranial tumors. The key points of prevention and treatment are that the relevant measures should be taken before and during operation, intensive care should be given after operation, and earlier diagnosis should be done.