迟发性颅内血肿致术中急性脑膨出的治疗

The treatment of delayed intracraniai hematoma-based acute encephalocele during brain injury operation

目的探讨在颅脑损伤术中因迟发性颅内血肿导致急性脑膨出的治疗经验。方法对由于迟发性颅内血肿所致42例颅脑外伤术中出现急性脑膨出患者的临床资料进行回顾性分析，总结术中脑膨出的原因及治疗措施。结果该组急性脑膨出均由迟发性颅内血肿引起，均及时彻底清除血肿。患者存活33例，3个月后按GOS评定治疗效果康复良好20例，中度残废6例，重度残废4例，植物状态生存3例。结论术中出现急性脑膨出时应及时复查头部CT，明确迟发性颅内血肿后，应彻底清除血肿。

Objective To investigate the experience in the treatment of acute encephalocele associated with delayed intracranial hematoma during severe brain injury operation. Methods 42 patients suffered from acute eneephaloeele during brain injury operation were,retrospectively analyzed. Results All patients with acute encephalocele were associated with delayed intracranial hematoma. The effective treatment of acute encephaloeele was to remove the hematoma out of the brain timely and thoroughly. 33 patients survived the disorder of acute encephalocele, of which, good recovery occurred in 20 patients, moderate disability in 6 patients, severe disability in 4 patients, and vegetative state in 3 patients according to Glasgow Outcome Score 3 months later. Conclusion Head-CT scanning should be timely performed when intraoperative acute encephalocele occurred ,whereas the measures of efficacy improvement on acute encephalocele were to timely.