颅脑损伤后迟发性张力性气颅13例临床分析

Clinical analysis of 13 cases with delayed tension pneumocephalus after craniocerebral injury

目的 探讨颅脑损伤后迟发性张力性气颅的临床表现、发病机制与治疗方法.方法 选取本院收治的13例颅脑损伤后迟发性张力性气颅患者,其中2例行保守治疗,其余均行急诊钻孔排气术.对治疗无效的4例患者行开颅血肿清除术.颅内感染2例患者行细菌培养并做药敏试验,根据药敏试验选择合理的抗生素治疗.结果 所有患者治疗1～4周后颅内积气均完全吸收.出院后随访3个月,无复发.结论 颅脑损伤后张力性气颅重在预防,通过头颅CT扫描、MRI等影像学定期检查,明确疾病的严重情况后采取合适的对症治疗手段可获得良好治疗效果.

Objective To explore the diagnosis, pathogenesis, treatment and prevention of delayed tension pneumocephalus after craniocerebral injury. Methods 13 cases with delayed tension pneumocephalus after craniocerebral injury were selected as the research objective, in which 2 cases received conservative therapy, the rest received emergency burr hole drainage. 4 cases invalid in conservative treatment or emergency drilling operation received craniotomy. 2 cases with intracranial infection con＇： ducted bacterial culture and drug sensitive test,then were given rational and sensitive antibiotics by the results of drug sensitive test. Results All the cases were cured and pneumatosis was completely absorbed within 1 -4 weeks after treatment. After 3 months follow--up, there was no relapse. Conclusion The timely examination of CT, and MRI can be helpful for the accurate diagnosis of delayed tension pneumocephalus after craniocerebral injury . Appropriate sugery and symptomatic treatment can have good efficacy after accurate diagnosis of it.