CAJ | 학술논문

目的：探讨重型颅脑损伤开颅术中急性脑膨出的形成因素及治疗方法。方法对我院2012年2月～2013年2月期间36例重型颅脑损伤开颅术中出现急性脑膨出患者的临床资料进行回顾性分析。结果导致患者出现急性脑膨出的因素有：弥散性脑肿胀、迟发性颅内血肿形成、3h以上的脑疝、长时间脑组织缺血缺氧、广泛性严重脑挫裂伤等。根据格拉斯哥评分标准进行评估，死亡16例（44.4%），恢复良好6例（16.7%），轻度残疾4例（11.1%），重度残疾7例（19.4%），植物生存3例（8.4%）。结论针对不同病因采取相应措施可有效治疗重型颅脑损伤开颅术中急性脑膨出，迅速清除颅内血块以及控制颅内压，降低患者的死亡率和致残率。
목적：탐토중형로뇌손상개로술중급성뇌팽출적형성인소급치료방법。방법대아원2012년2월～2013년2월기간36례중형로뇌손상개로술중출현급성뇌팽출환자적림상자료진행회고성분석。결과도치환자출현급성뇌팽출적인소유：미산성뇌종창、지발성로내혈종형성、3h이상적뇌산、장시간뇌조직결혈결양、엄범성엄중뇌좌렬상등。근거격랍사가평분표준진행평고，사망16례（44.4%），회복량호6례（16.7%），경도잔질4례（11.1%），중도잔질7례（19.4%），식물생존3례（8.4%）。결론침대불동병인채취상응조시가유효치료중형로뇌손상개로술중급성뇌팽출，신속청제로내혈괴이급공제로내압，강저환자적사망솔화치잔솔。
Objective To explore the causes and therapeutic methods of acute cephalocele of craniotomy patients with severe craniocerebral injury. Methods The clinical data of 36 cases acute cephalocele patients taken craniotomy with severe craniocerebral injury from Feb 2012 to Feb 2013 in our hospital were retrospectively collected and analyzed. Results Diffuse brain swelling, delayed intracranial hematomas, cerebral hernia(>3h), longtime ischemia and anoxia of the brain tissue, severe cerebral contusion leading to acute cephalocele in the craniotomy. According to Glasgow coma score (GOS),16 cases (44.4%) were dead, 6 cases (16.7%) were good, 4 cases (11.1%) mildly disabled, 7 cases (19.4%) were seriously disabled, 3 cases (8.4%) survived in a permanent vegetative state. Conclusion Taking proper measures according to disable causes can effec-tively treat the acute cephalocele in the craniotomy with severe craniocerebral injury , which will reduce the mortality and dis-ability rate.