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目的:探讨重型颅脑损伤开颅术中急性脑膨出原因及有效防治措施。方法:回顾性分析35例重型颅脑损伤开颅术中发生脑膨出的原因及防治措施的疗效。结果:术中迟发性颅内血肿形成、外伤后急性弥慢性脑肿胀、长时间脑组织缺血缺氧是重型颅脑损伤开颅术中并发急性脑膨出的主要原因,本组病例死亡19例(54.3%),存活16例(45.7%)。结论:彻底清除颅内血肿,充分减压,控制血压,改善脑部缺血缺氧是预防及治疗术中脑膨出的有效措施。
Objective: To investigate the causes of acute encephalocele during craniotomy in severe craniocerebral injury and its effective prevention and treatment. Methods: Retrospective analysis of 35 cases of severe craniocerebral injury occurred during craniotomy and prevention and treatment of curative effect. Results: Delayed intracranial hematoma occurred during operation, acute diffuse brain swelling after trauma and prolonged cerebral ischemia and hypoxia were the main causes of acute cerebral edema in craniocerebral trauma patients with severe craniocerebral injury. In this group of patients died Nineteen patients (54.3%) survived in 16 patients (45.7%). Conclusion: The complete removal of intracranial hematoma, adequate decompression, blood pressure control, and improvement of cerebral ischemia and hypoxia are effective measures to prevent and treat intraoperative encephalocele.