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目的探讨重型颅脑损伤开颅术中急性脑膨出的原因及治疗方法。方法对开颅术中出现急性脑膨出的37例患者进行回顾性分析。手术采用标准外伤大骨瓣开颅,术中采用过度通气、控制性降压以及内减压等措施,必要时行双侧开颅去骨瓣减压。结果术后随访3～6个月,按GOS标准评估愈后,恢复良好4例,中、重残5例,植物生存8例,死亡20例。结论重型颅脑损伤术中出现急性脑膨出的原因是多方面的,针对不同原因采取不同措施,可以改善预后。
Objective To investigate the causes and treatment of acute brain bulge in craniocerebral injury of severe craniocerebral injury. Methods A retrospective analysis of 37 patients with acute encephalocele during craniotomy was performed. Surgery using standard trauma craniectomy, intraoperative hyperventilation, controlled hypotension and decompression and other measures, if necessary, bilateral craniotomy decompression. Results The patients were followed up for 3 to 6 months. According to GOS criteria, 4 cases recovered well, 5 cases were moderately and severely disabled, 8 cases were plant survival and 20 cases died. Conclusion There are many causes of acute encephalocele during severe craniocerebral injury. Different measures for different reasons may improve the prognosis.