颅脑损伤术中急性脑膨出的原因分析及手术策略

目的探讨颅脑损伤术中急性脑膨出的原因和手术处理。方法对34例颅脑外伤开颅术中出现急性脑膨出患者的临床资料进行回顾分析。结果进展性颅内血肿和急性弥漫性脑肿胀是颅脑损伤术中发生急性脑膨出的主要原因。迟发性颅内血肿的处理、双侧去骨瓣等可以降低颅脑外伤术中急性脑膨出的致重残率和致死率。术中及时复查CT可以为下步手术方案提供确凿的临床证据。结论颅脑损伤开颅术中急性脑膨出由多种因素引起,针对病因采取综合治疗是降低致残率和病死率的关键。

Operation strategy of acute intraoperative brain swelling of craniocerebral injury

Objective To discuss the causes and operation strategy of acute brain swelling during the operation of eranioeerebral injury. Methods We reviewed and analyzed the clinical data of 34 patients with eraniocerebral trauma who received craniotomy with the occurrence of acute brain swelling. Result The main causes of acute brain swelling during the operation of severe cranioeerebral injury were delayed intracranial haematoma and acute diffuse brain swelling. Processing, bilateral delayed intracranial hematoma removing bone valve can reduce the acute brain swelling in craniocerebral injury operation caused by the severe disability rate and death rate. Intraoperative timely review of CT can provide irrefutable evidence for clinical operation program for the future. Conclusion There are many causes of brain swelling. Etiological treatment is the key to reducing morbidity and mortality.