【摘要】 目的 探讨重型颅脑损伤开颅术中急性脑膨出的原因及对策。方法 对120例重型颅脑损伤开颅术中急性脑膨出的原因、对策及预后进行回顾性分析。结果 (1)迟发血肿65例，其中同侧脑内血肿10例，硬膜外血肿8例，对侧硬膜外血肿21例，硬膜下血肿10例，脑内血肿9例，大脑纵裂血肿7例；(2)急性弥漫性脑肿胀40例；(3)外伤性大面积脑梗死15例；(4)复合伤患者有30例。合并胸部、腹部及四肢骨折，有明显的低血压和低血氧症状；(5)术中操作不当，误诊误治10例。结论 重型颅脑损伤开颅术中急性脑膨出的主要原因有迟发性颅内血肿,弥漫性脑肿胀，严重脑水肿，广泛脑梗死，术中操作不当，对病情的误诊误治，麻醉问题等。根据不同的原因进行正确处理，可以降低急性脑膨出的重残率及病死率。

    【关键词】 重型颅脑损伤；急性脑膨出；防治

    The management intraoperative acute encephalocele with severe craniocerebral injury

    WU Zhi-feng，HE Yong-yuan，MAO Zhi-gang.

    Department of Neurosurgery, The People’s Hospital of Panyu,Guangzhou 511400，China

    【Abstract】 Objective To study the cause and tactic of intraoperative acute encephalocele with severe craniocerebral trauma. Methods 120 patients with intraoperative acute encephalocele were retrospectively studied for: the cause, tactic, and prognosis.Results The major reason for intraoperative acute encephalocele were delayed intracranial hematomas, diffused cerebroswelling, severity encephal edema, extensive cerebral infarction, misprocedure, misdiagnosis and mistherapeutic methods,etc.Conclusion We used different method to treat different problem, and it could decrease the incidence and fatality rate for acute encephalocele patients. ......