37例外伤性迟发性颅内血肿的诊治体会  

Experience to Diagnosis and Treat 37 Cases with Delayed Traumatic Intracranial Hematomas

作　　者：李孝生[1] 陈家玉[1] 林云东[1] 朱贤立[2] 赵洪洋[2] 

机构地区：[1]湘南学院附属医院神经外科,423000 [2]华中科技大学同济医学院附属协和医院神经外科

出　　处：《中国实用医药》2010年第15期46-48,共3页China Practical Medicine

摘　　要：目的探讨外伤性颅内迟发性血肿的临床特点、机制及治疗。方法回顾性分析近5年来收治的37例外伤性颅内迟发性血肿的临床资料。31例行颅骨切除清除血肿减压,6例在显微镜下行小骨窗切开清除血肿。结果本组37例再次行开颅血肿清除术。恢复良好15例,中残9例,重残5例,植物生存1例,死亡7例。结论脑挫伤、蛛网膜下腔出血、颅骨骨折、高龄为外伤性迟发性颅内血肿的高危因素,降低外伤性颅内迟发性血肿病死率和致残率的关键在于早期诊断和治疗,临床应采取相应的有效预防措施,并强调严密观察病情变化、及时复查CT,以便及时发现并再次手术清除继发性血肿。Objective To investigate the clinical features, mechanisms and treatment of delayed traumatic intracranial hematoma （DTICH ）.Methods Thirty-seven cases of DTICH were analysed retrospectively in the study. The hematoma in 31 cases were removed and decompressed by crinial bone resection and 6cases were removed by means of craniotomy with small bone window resection under microscope. Results Good recovery occurred in 15patients;moderate disability in 9patients; severe disbility in 5 patients,persistent coma in 1patients and death in 7 patients. Conclusion Cerebral contusion,subarachnoid hemorrhage,skull fracture and senility are dangerous factors of DTIH. Early diagnosis and treatment is key to successful treatment of patients with DTICH. In the patients with acute traumatic intracranial hematomas the disease condition should be closely observed and cranial CT should be reexamined in time.

关 键 词：颅脑外伤 迟发性颅内血肿 治疗 

分 类 号：R651.15[医药卫生—外科学]