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目的探讨手术因素对重型颅脑损伤并发脑梗死的影响。方法对33例重型颅脑损伤术后并发脑梗死的病例进行回顾性分析。结果重型颅脑损伤术后并发脑梗死多发生在术后24h~7d,手术侧大于非手术侧,多见颞叶、额叶、枕叶,外伤性脑梗死者多伴有严重的脑水肿或脑肿胀以及广泛性蛛网膜下腔出血。结论重型颅脑损伤早期手术治疗对控制顽固的颅内高压,防止脑疝的发生,改善患者的预后有着重要的意义,但手术范围,手术中器械刺激,血管损伤,出血过多等因素有可能增大术后并发脑梗死的概率。
Objective To investigate the influence of surgical factors on severe cerebral injury complicated by cerebral infarction. Methods Retrospective analysis of 33 cases of severe cerebral injury complicated with cerebral infarction. Results Severe craniocerebral injury complicated with cerebral infarction occurred mostly in 24h ~ 7d after operation. The operative side was larger than the non-surgical side. Most of the patients with temporal lobe, frontal lobe, occipital lobe and traumatic cerebral infarction were accompanied by severe cerebral edema or Brain swelling and extensive subarachnoid hemorrhage. Conclusion Early surgical treatment of severe craniocerebral injury is of great importance in the control of intractable intracranial hypertension, preventing the occurrence of hernia and improving the prognosis of patients. However, such factors as the scope of operation, the stimulation of instruments during operation, vascular injury and excessive bleeding are possible Increase the probability of postoperative cerebral infarction.