重型颅脑创伤术中脑膨出原因及防治措施

The Cause and Prophylactic-therapeutic Measures of the Acute Encephalocele during Operation

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 explore the cause and prophylactic-therapeutic measures of the acute encephalocele during traumatic cerebral operation. Methods： Analysis the cause and prophylactic-therapeutic measures of the acute encephalocele of 29 patients was made from January 2000 to December 2008. Results ： Of 29 patients after severe head injury and acute encephalocele during operation, 15 patients died （51.72%）, among them 10 patients due to acute brain swelling,6 died; 8 patients due to delayed intracranial hematoma,2 died, GOS score six month after operation： 3 patients have favorable score（37.5% ）, 2 patients have moderate maim （25%） ; 11 patients due to other causes, 7 died. Conclusions： The cause of the acute encephalocele during traumatic cerebral operation are acute brain swelling and delayed intracranial hematoma （ 18/29, 62.06% ） , usage of the effective treatment according to the cause may play an impartment role in improving the clinical effects.