横窦骑跨性硬膜外血肿的早期诊断及术式改进  

Early diagnosis and operative method improvement of epidural hematoma straddling transverse sinus

作　　者：龙霄翱[1] 陈兵[1] 罗学忠[1] 陈立一[1] 王东军[1] 赵革灵[1] 

机构地区：[1]广东医学院附属医院神经外科,湛江524001

出　　处：《中华神经医学杂志》2005年第11期1171-1172,共2页Chinese Journal of Neuromedicine

摘　　要：目的探讨横窦骑跨性硬膜外血肿的临床特征、早期诊断、手术方式及疗效。方法分析48例横窦骑跨性硬膜外血肿的临床资料、术式改进及疗效。血肿﹤10mL者采用“旁正中切口+窦上缘旁钻孔”术。血肿≥10mL者可采用“枕后马蹄形切口+跨横窦下缘骨瓣”,“枕下倒钩形切口+跨横窦上缘骨瓣”,“幕上、下‘S’型切口+跨横窦骨瓣”等术式。结果全部病例经CT确诊并手术,横窦减压效果良好。结论由于缺乏典型的临床特征,早期诊断依赖头CT扫描。改进的术式能更好地避免横窦受压,预防致命性脑疝。Objective To discuss the clinical characteristics, early diagnosis, operative methods and therapeutic efficacy of the epidural hematoma straddling the transverse sinus. Methods The clinical data, surgical method improvement and curative effect of 48 cases with epidural hematoma straddling the transverse sinus were analyzed. “Paramedian incision＋ drilling by the upper edge of transverse sinus” was adopted in the cases with hematoma 〈 10 mL; “post-occipital hook incision＋bone flap straddling the lower edge of the sinus”,“suboccipital reverse hook incision＋bone flap straddling the upper edge” or “supratentorial and subtentorial S＇ incision ＋bone flap straddling the sinus” was applied in the cases with hematoma ≥ 10 mL. Results The pressure on the sinus was relieved effectively in all cases. Conclusion Early diagnosis depends on CT scan since these cases have no typical clinical features. The pressure on the sinus can be relieved effectively and the fatal cerebral hernia be avoided by the improved operative methods.

关 键 词：横窦 血肿 硬膜外 颅内 外科手术 

分 类 号：R651.15[医药卫生—外科学]