手术治疗急性颅内血肿合并脑疝临床分析

Clinical Analysis of Surgical Treatment of Acute Intracranial Hematoma Combined Cerebral Hernia

目的:探讨急性外伤引起的颅内血肿合并脑疝救治、降低死亡率及致残率的切实可行方法。方法:对我科2000年1～2009年1月救治的56例急性外伤性颅内血肿合并脑疝患者的临床资料回顾性分析。结果:56例患者均行手术治疗,其中硬膜下血肿18例、硬膜外血肿31例、混合性颅内血肿7例;血肿量在40～160ml;按GOS标准恢复良好32例,中度残废4例,重残废4例,无植物生存,死亡16例。恢复良好率57.1%,残疾率14.3%,死亡率28.6%。结论:急性外伤性颅内血肿合并脑疝患者发病后,应及早去骨瓣减压加颅内血肿清除,同时控制脑水肿,防止肺部感染及多器官功能衰竭,降低死亡率,提高生存率。

Objective：This article is to explore the methods how to treat the acute traumatic intraeranial hematoma complicated by cerebral herniation, and reduce death rate and disability rate in practical ways.Methods：Make an analyze on the 56 clinical cases of acute traumatic intracranial hematoma complicated with brain herniation patients in our department from January 2000 to January 2009.Results：All together 56 patients have underwent the surgical treatment, in which t8 cases of subdural hematoma,31 cases of epidural hematoma,7 cases of Mixed intracranial hematoma;hematoma volume of 40-160ml;according to GOS criteria,32 cases recovery well,4 cases of moderate disability,4 cases of re-disability, no plant life,16 cases of death.A good recovery rate of 57.1%,disability rate of 14.3%,mortality rate of 28.6%.Conclusion： The acute traumatic intracranial hematoma complicated by herniation patients should dislodge bone flap and reduce the pressure and get rid of the tumor in the skull,while controlling brain edema and preventing lung infection and multiple organ failure,That will reduce the death rate and increase the survival rate.