脑外伤术中并发进展性硬膜外血肿临床分析

Clinical analysis of progressive epidural hematoma during the operation of brain traumatic injury

目的 分析脑外伤开颅术中出现急性脑肿胀、脑膨出的原因,以及进展性硬膜外血肿的形成原因、诊断及治疗方法。方法 回顾分析381例因脑外伤开颅患者临床资料,其中术中并发进展性硬膜外血肿27例。结果 除9例因脑干功能衰竭死亡外,18例患者均临床治愈出院。结论 对于术中出现急性脑肿胀、脑膨出的患者一定要迅速查明原因,特别是术前对侧有颅骨骨折及硬膜外血肿的患者,立即复查头颅CT,立即手术治疗,切勿盲目切除膨出的脑组织,强行关颅,否则患者预后不良。

Objective To analyze the cause of acute brain swelling,brain encephalocele in brain traumatic injury craniotomy,and the reason,diagnosis and treatment methods of progressive epidural hematoma.Methods The clinical data of 381 patients with brain traumatic injury craniotomy were retrospetively analyzed.Of 318 patients,27 cases had progressive epidural hematoma during operation.Results 9 cases died because of functional failure of brain stem,the other 18 cases were all clinically cured.Conclusion If acute brain swelling and encephalocele occured during operation,the cause should be found quickly,especially when there was skull fracture or epidural hematoma on the contralateral brain,the head CT and operation should be taken immediately,and the bulging brain tissue should not be removed blindly,and the skull should not be forced to close,otherwise the prognosis maybe poor.