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Wysłany: Pią 7:43, 11 Mar 2011
Temat postu: asics shoes online Special activity of epidural he
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Special activity of epidural hematoma with acute cerebral herniation caused by treatment of 30 cases of experience
See epidural hematoma of uniform spindle high density. Bleeding was mainly due to increased dynamics. In the blood is not completely solidified,
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, it can affect the performance of high-density I. Hematoma was due to acute progressive expansion,
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, so the rapid progression of the disease,
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, the group from the injury to the side of the mydriasis, the fastest time by 30min,
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, the slowest 90min, an average of 60min. Experience has shown that development of the disease such as dilated pupils time to double-> 60rain surgical significance is lost. <30min as soon as possible by surgery. Most patients can save lives: and the good prognosis of intracranial hematoma based l4I. Therefore, surgery should be stressed that as soon as possible, to avoid excessive delay in checking the best treatment opportunity. This group of patients within 2h after injury to remove the hematoma, hematoma surgery were significantly greater than seen in CT shown in hematoma volume. 6.67% mortality rate in this group was lower than that reported in the literature I】 63%. Operation Note: the face of potential massive blood loss have a full understanding, more than 2000ml blood loss in this group 8 cases (26.7%), it should be an ample supply of preoperative blood volume (2000 ~ 3000m1), cranial bone scope should be CT shows hematoma greater than the scope of exposure of blood to patients. If considered for the middle meningeal artery blood should be close to the base of the skull bone. Drilling may be part of hematoma to relieve the suction pressure on the brain. The group of middle meningeal artery bleeding 2l (70%), including 8 cases of complete rupture, the bleeding rate of speed than the attraction suction. Caused by poor visibility and difficult surgery to stop bleeding. Abrupt decline in blood pressure: at this time should be temporary with a cotton pad to stop bleeding brain, or cut the dura mater, for a diameter of about 2CITI holes, a stretch that people will be in subdural bleeding within the skull up to the plate pressure temporarily bleeding, blood pressure to blood pressure was stable; and 2 sets of suction equipment simultaneously, to see the bleeding point coagulation, such method still does not work then find the foramen spinosum to the base of the skull and bone wax or with a close packing of small particles of cotton foramen spinosum stop the bleeding. Damage the superior sagittal sinus blood soaked fibrin glue is applied in the gelatin sponge, and flip around the dural closure pressure increases with. Beam or suspended in the bone bleeding: If the sinus sinus repair damaged lines should be larger, such as sinus 1 / 3 broken bleeding suture method is applied to stop bleeding. Treated by this group, we believe that activity of special acute epidural hematoma caused by a large herniation in patients with disease progression, although abrupt, but as long as the establishment of a sound specialist pre-hospital emergency mode, timely diagnosis, race against time to rescue operations, he will be satisfied with the results.
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