目的:探讨颅脑损伤患者术中急性脑膨出的病因、诊断及治疗。方法:对127例术中发生急性脑膨出的颅脑损伤患者的临床资料进行回顾性分析。结果:急性脑膨出的原因为同侧脑肿胀者74例,为对侧迟发性血肿者51例,而为同侧迟发性血肿者2例。共死亡48例(37.8%),其中31例因脑疝死亡。结论:通过钻孔探查或积极的CT扫描,及时发现颅脑损伤患者术中急性脑膨出的原因,并尽早正确处理极其重要,是抢救此类患者成功的关键。 Objective: To explore the etiology, diagnosis and treatment of acute intracerebral edema in patients with craniocerebral injury. Methods: A retrospective analysis was performed on the clinical data of 127 patients with acute brain encephalocele injury. Results: The causes of acute encephalocele were ipsilateral brain swelling in 74 cases, 51 cases of contralateral delayed hematoma, and 2 cases of ipsilateral delayed hematoma. A total of 48 deaths (37.8%), of which 31 died of herniation. CONCLUSION: Finding the cause of acute encephalocele in patients with craniocerebral injury by drilling exploration or positive CT scan and treating them correctly as soon as possible is the key to the success of such patients.