外伤性急性硬膜下血肿的穿刺清除治疗  

key-hole drainage for acute traumatic subdural hematoma

作　　者：单宝昌 成立峰[3] 荆日松 张留龙 

机构地区：[1]东营市人民医院神经外科,257091 [2]东营市人民医院放射科,257091 [3]胜利油田中心医院神经外科 [4]东营市第二人民医院神经外科

出　　处：《中华创伤杂志》2012年第10期901-904,共4页Chinese Journal of Trauma

摘　　要：目的探讨急性硬膜下血肿微创穿刺清除治疗的疗效。方法回顾性分析35例急性硬膜下血肿患者，CT定位引导穿刺抽吸、液化、引流血肿，1—3d内血肿基本清除后拔出穿刺针。结果术后24h内复查CT示血肿减少〉80％。意识清醒者穿刺后头痛、呕吐症状明显好转。6个月后格拉斯哥预后评分（GOS）：5分16例，4分15例，3分4例。继发脑积水1例，癫痫2例。结论选择性应用一次性穿刺针穿刺清除治疗急性硬膜下血肿疗效可靠，并发症少，可显著改善患者预后。Objective To investigate the effects of minimally invasive key-hole drainage for trea- ting acute suhdural hematoma. Methods Thirty-five patients with acute subdural hematoma treated by key-hole drainage were retrospectively analyzed. CT-oriented key-hole drainage was performed to aspirate, liquefy and drain hematoma. The transfixion pin was removed after hematoma was basically cleared within 1 to 3 days. Results Hematoma volume decrease was greater than 80% by follow-up CT 24 hours postoperatively. Headache and vomiting in the preoperative conscious patients were significantly relieved after key-hole drainage. Glasgow Outcome Score （GOS） was 5 points in 16 patients, 4 points in 15 and 3 points in four six months postoperatively. One patient was complicated with hydrocephalus and two with epilepsy. Conclusions Key-hole drainage with disposable transfixion pin selective employed for patients with acute subdural hematoma is effective and has few complications. The treatment notably improves prognosis of the patients.

关 键 词：血肿 硬膜下 急性 穿刺抽液术 格拉斯哥预后评分 

分 类 号：R651.15[医药卫生—外科学]