颅内血肿术后并发脑梗死71例临床分析

The clinincal analysis of 71 cases with the cerebral infarction after traumatic intracranial hematomas removal

目的探讨外伤性颅内血肿术后并发脑梗死的相关原因。方法对71例颅内血肿术后并发脑梗死的病例进行回顾性分析。结果颅内血肿术后并发脑梗死多发生在术后24～72h,手术侧大于非手术侧,多见颞叶、额叶、枕叶,并发大面积脑梗死者多伴有严重的脑水肿或脑肿胀以及广泛性蛛网膜下腔出血。结论急性颅内血肿术后并发脑梗死的主要原因是微循环障碍和脑血管的损伤,而过度脱水及手术操作误伤血管、异常血糖增高等代谢异常是其重要因素,会进一步加重梗死区的损害。

Objective To explore the relative causes of the cerebral infarction after traumatic intracranial hematomas removal.Methods 71 patients with cerebral infarction after traumatic intracranial hematomas removal were retrospectively analysed.Results The cerebral infaction after intracranial hematomas removel mostly took place during 24～72 hours after the operation.The nembers of the focus on the operation side were more than non-operation side.The majority of the infarction occured in temporal,occipital and frontal lobe.The great aren infarction often came along severe edema of brain and wilder subarechnoid hemonrhage.Conclusions The primary causes of the cerebral infarction after traumatic intracranial hematomas remoral were the microcirculation malfunction and the cerebrovascular damage.The ecessive dehydration,the incorrect damage of the cerebral vascular in the operations and the abnormal blood glucose raising were important elements.They could intensify the damage of the cerebral infanition focuses further.