摘要
目的 探讨急性硬膜外血肿患者术后脑水肿发生的机制及其影响因素和术中去骨瓣减压的指征。方法 将 170例急性硬膜外血肿患者分为水肿组和无水肿组两组。根据患者格拉斯哥评分、瞳孔大小、血肿量、CT或MR检查脑中线移位程度 ,结合手术时间、血肿部位、年龄及是否有原发昏迷等进行统计学分析。结果 两组在术前格拉斯哥评分 ,瞳孔进行性散大、血肿量增大、脑中线结构移位程度加重 ,手术拖延等方面均有显著性差异 (P <0 .0 1) ;而在血肿部位、年龄、是否有原发昏迷等未见明显关系。结论 急性硬膜外血肿术后脑水肿主要是急性脑受压造成的 ;脑受压程度越重、时间越长 ,术后脑水肿越严重 ;早期手术是避免或减轻术后脑水肿的有效措施 ,对术后发生较大范围的脑水肿病例应及时去骨瓣减压。
Objective To explore the mechanism of brain edema and its affecting factors after the treatment in acute extradural hematoma and the signs of bony decompression.Methods 170 cases of acute epidural hemotoma were divided into edema and nonedema groups.Statistical analysis was based on eight factors of GCS,diameter of pupils,amount of hematoma,the moved degree of brain midline in CT or MRI,age,and original coma.Results The two groups had much significant difference in five factors of preoperative GCS,progressive pupils expanding,the degree of brain midline moved,and delayed operation(P<0.01).Surgical hematoma,age,and original coma existing had no significant difference between groups.Conclusion Brain edema of acute epidural hemotoma resulted by acute brain oppression.The more serious and longer time of brain oppressed,the more severe brain edema caused after operation.Early operation can avoid and alleviate the edema.Bony decompression should be performed in time for the patients with large brain edema.
出处
《中国综合临床》
北大核心
2005年第1期45-47,共3页
Clinical Medicine of China
关键词
硬膜外血肿
脑水肿
外科手术
Epidural hematoma
Brain edema
Surgical operation
