重型颅脑损伤术中急性脑膨出防治体会（附45例报告）

目的探讨颅脑损伤手术中急性脑膨出的形成原因及有效的防治措施。方法对手术中出现脑膨出的45例颅脑损伤病人进行回顾性分析，总结其开形成原因及易发征象，比较各种防治措施的疗效。结果术中迟发性颅内血肿的形成、急性弥漫性脑肿胀、脑组织缺氧和低血压、长时间脑疝、严重脑挫裂伤等是颅脑损伤术中急性脑膨出的主要原因，彻底清除颅内血肿、缓慢降低颅内压、术中过度通气、使用脱水剂、适当控制血压是防治术中脑膨出的有效措施。结论针对不同病因采取相应措施可防治颅脑损伤术中脑膨出，可取得较好疗效。

The prevention and treatment experience of acute encephalocele during severe brain injury operation(A report of 45 cases)

Objective：To summarize the causes and treatment of acute encephalocele during severe brain injury operation. Methods： The clinic data of 45 patients with acute encephalocele during severe brain injury operation were analyzed retrospectively. Results： Delayed intracranial hematoma, acute diffuse cerebral swelling, cerebral anoxia and hypotension, long-term cerebral hernia and severe contusion and laceration of brain were the main causes of intraoperative encephalocele, and many ways were implemented to deal with it, such as complete clearance of hematomas, decreasing intracranial pressure slowly, intraoperative hyperventilation, diuretics, maintaining systolic blood pressure properly. Conclusion： Adopting corresponding measures according to the different cause can improve therapeutic effect of intraoperative encephalocele.