重型颅脑外伤术中急性脑膨出的治疗体会

目的探讨重型颅脑外伤术中发生急性脑膨出的治疗。方法回顾性分析34例重型颅脑损伤术中急性脑膨出患者的临床资料,应用标准大骨瓣切口开颅,清除血肿或减压,对关颅困难者选择性切除部分膨出非功能区脑叶后关颅。结果本组34例患者中,单侧大骨瓣减压8例;双侧开颅26例,术后疗效采用GOS标准,于伤后治疗6个月评定结果:恢复良好7例;轻残4例,中残3例,重残1例,术后植物生存1例;死亡18例。结论脑外伤术中急性脑膨出的主要原因为迟发性颅内血肿和弥漫性脑肿胀,手术中处理正确,可以减少脑膨出的发生。

The Treatment Experience of Acute Encephalocele During the Operation of Severe Craniocerebral Trauma

Objective To explore the treatment of acute encephalocele occurred during the operation of severe craniocerebral trauma.Methods 34 cases of acute encephalocele occurred during the operation of severe craniocerebral trauma in patients with clinical data were retrospectively analyzed,application of the standard large trauma craniotomy incision,remove the hematoma or reduced pressure,to close cranial difficulty parts,after turning-by selective removal of part of cranial non-functional areas of brain swelling closed cranial lobe.Results The group of 34 patients,unilateral hemicraniectomy 8 cases;bilateral craniotomy in 26 cases,the curative effect was standard by GOS,in the treatment for 6 months after injury assessing results：good recovery in 7 cases;4cases of mild disability,the residual 3 cases,severe disability in 1 case,after the plants survive in 1 case;18 patients died.Conclusion The main reason of of acute encephalocele during the severe craniocerebral trauma in the operation was the delayed intracranial hematoma and diffuse brain swelling,and surgery to deal with correctly,can reduce the occurrence of encephalocele.