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目的 减少颅脑肿瘤手术后血肿的发生,改善患者预后。方法 分析自1991年7月～2001年6月发生的脑肿瘤手术后颅内血肿12例,包括血肿发生率、血肿部位与出现时间、相关因素及预防处理等。结果 术后血肿出现的高峰时间在8h内,血肿好发部位为额顶硬膜外。远隔部位术后血肿的发生与过分急骤颅压改变有关;手术野血肿与止血是否恰当、引流管放置及颅脑各层结构的完整性有关。术后血肿的发生与肿瘤病理性质、部位无关,与患者的脑血管状况有关。结论 术后8h内强化监护并及时处理血肿对改善患者预后至关重要。
Objective To reduce the occurrence of hematoma after craniocerebral tumor surgery and improve the prognosis of patients. Methods 12 cases of intracranial hematoma after brain tumor operation occurred from July 1991 to June 2001, including the incidence of hematoma, the location and time of hematoma, the related factors and the prevention and treatment. Results The peak time of postoperative hematoma appeared in 8h, and the site of hematoma was forehead epidural. The occurrence of hematoma in the distant site is related to the sudden change of intracranial pressure. The surgical hematoma is related to whether hemostasis is appropriate, the placement of the drainage tube and the integrity of the structure of brain layers. The occurrence of postoperative hematoma and pathological nature of the tumor site has nothing to do with the status of patients with cerebrovascular disease. Conclusions Intensive care and timely treatment of hematoma within 8 hours after operation are of crucial importance for improving the prognosis of patients.