外伤性急性广泛硬膜下血肿的诊治策略  

Diagnosis and Treatment of acute subdural hematoma

作　　者：张明文[1] 赖润龙[1] 李勇[1] 张填波[1] 陈煜[1] 

机构地区：[1]汕头大学医学院第一附属医院神经外科,广东省汕头515041

出　　处：《中国基层医药》2011年第2期150-152,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨急性广泛硬膜下血肿的临床特点及诊治策略。方法收集94例经CT证实并经手术治疗的急性硬膜下血肿患者资料，据CT表现分为单纯型急性硬膜下血肿15例、复合型急性硬膜下血肿79例并进行回顾分析。结果按照格拉斯哥预后评分：治愈36例，中残19冽，重残17例，死亡22例，病死率为23．4％。结论判断出血来源是单纯型急性硬膜下血肿手术治疗的关键，复合型广泛硬膜下血肿伤情特点导致其预后较单纯型差，采取早期大骨瓣减压术可明显降低颅内高压从而改善患者预后，提高患者生存率、降低病死率及减少术后并发症的发生。Objective To investigate the clinical characteristics and therapeutic strategy of acute subdural hematoma. Methods A restrospective study was carried out with a total of 94 consecutive ASDH patients who were confirmed through computed tomographic scan and obtained the clinical characteristics by experienced neurosurgeons. 15 eases were pure acute subdural hematoma and the other 79 eases were acute compound subdural hematoma accord- ing to CT scan. Results In accordance witb the GOS,36 cases had good recovery, 19 eases had moderate disability, 17 cases had severe disability and 22 cases dead. Conclusion The most important treatment for pure acute subdural hematom was to diagnose the source of bleeding, and acute compound subdural hematoma had poor prognosis than pure acute subdural hematoma since the traumatic severity. Early decranium by large bone flap to treat acute compound subdural hematoma could improve survival rate,reduce the fatality rate and decrease postoperative complications.

关 键 词：颅脑外伤 急性硬膜下血肿 标准大骨瓣开颅术 并发症 

分 类 号：R651[医药卫生—外科学]