术中迟发性硬膜外血肿防治体会(附10例报告)  

Intraoperative Prevention and Treatment of Delayed Epidural Hematoma(Report of 10 cases)

作　　者：俞辉[1] 李高义[1] 杨文进[1] 何斌[1] 郑平[1] 郭义君[1] 童武松[1] 

机构地区：[1]上海浦东新区人民医院神经外科,上海浦东201200

出　　处：《现代生物医学进展》2011年第24期4942-4944,共3页Progress in Modern Biomedicine

摘　　要：目的:探讨颅脑外伤手术中出现迟发性硬膜外血肿(DEDH)的原因及预防对策。方法:回顾性分析10例手术过程中DEDH发生的原因、现象,治疗过程、结果及预后等临床资料。结果:10例DEDH发生于伤后72h以内、手术减压后,6例伴有颅骨骨折,3例伴静脉窦损伤。7例术前甘露醇用量超过500ml,经手术清除和保守治疗,死亡1例。结论:颅骨骨折和颅内静脉窦损伤是DEDH发生的病理基础,减压手术和甘露醇强力脱水治疗是其发生的促进因素,GCS评分和血肿持续时间与预后密切相关。Objective： To investigate the emergence of delayed surgery in the epidural hematoma（DEDH） the causes and preven-tive measures.Methods： A retrospective analysis of 10 cases of surgical procedures DEDH the causes,the phenomenon,treatment,clinical outcome and prognosis.Results： 10 cases DEDH occurred within 72h after injury,after surgical decompression,six cases with skull frac-tures,3 cases with venous sinus injury.Seven cases more than the amount of preoperative mannitol 500ml,after surgical removal and conservative treatment,1 died.Conclusion： The skull fracture and intracranial venous sinus injury is the pathological basis of the occur-rence DEDH,decompression surgery and mannitol dehydration treatment is a strong contributing factor to its occurrence,GCS score and hematoma duration and prognosis.

关 键 词：硬膜外血肿 迟发性 临床机制 预防 处理 

分 类 号：R651.15[医药卫生—外科学]