重型颅脑损伤术中急性脑膨出

目的 分析重型颅脑损伤手术中急性脑膨出的原因及防治措施。方法 对术中出现脑膨出的18例脑损伤病人进行回顾性分析、分析形成原因及防治措施。结果 急性弥漫性脑肿胀、迟发颅内出血、低氧血症、天幕裂孔疝所致脑干受压、广泛脑挫伤是颅脑损伤术中急性膨出的主要原因。降低颅压、清除迟发血肿、过度通气、使用脱水剂、提高胶体渗透压、控制血压是防治术中脑膨出的有效措施。结论 对于不同病因采取相应措施，可提高生存率。

The causes and treatment of acute intraoperative encephalocele at operating patients with severe head injury

Objective To summarize the causes and therapeutic methods of acute intraoperative encephalocele at operating patients with severe head injury. Methods The causes and therapeutic methods of acute intraoperative encephalocele in operating on 18 patients with severe head injury were retrospectively analyzed, with the preventive and treating methods summarized. Results Our analysis indicated that acute diffuse brain swelling, delayed intracranial heamatomas, cerebral anoxia, brain herniation and massive brain contussion and larceration were the main causes of intraoperative encephalocele; and the the methods of treatment included removal of heamatomas completely, decrease of intracranial pressure, intraoperative hyperventilation, large dose of mannitol and maintaining of systolic blood pressure. Conclusion The acute intraoperative encephalocele in patients with head injury can be effectively prevented and treated according to different causes.