迟发性外伤性颅内血肿的临床特点及预后因素  

Clinical Characteristics and Prognostic Factors of Delayed Traumatic Intracranial Hematoma

作　　者：刘玉光[1] 王宏伟[1] 吴承远[1] 朱树干[1] 李新钢[1] 李刚[1] 

机构地区：[1]山东医科大学附属医院神经外科,济南250012

出　　处：《中国临床神经外科杂志》2001年第1期11-12,共2页Chinese Journal of Clinical Neurosurgery

摘　　要：目的 研究迟发性外伤性颅内血肿(DTIH)的临床特点及预后因素。方法 回顾性分析了66例DTIH病人的临床资料。结果 DTIH常见于男性中老年减速性损伤者,以额颞部最多见,常发生于伤后72h;意识障碍进行性加重,逐渐出现局限性神经症状及局限性癫痫是其三个重要症状;低血压为促发因素。原发性脑损伤重,年龄超过60岁,诊断时间超过24h,术前GCS评分小于8分者死亡率高。结论 DTIH的临床表现具有其特点,正确认识该病、及时复查CT是早期诊断的关键;原发性脑损伤的程度、年龄、瞳孔变化、确诊时间、术前意识水平是影响其预后的主要因素。Objective To study the clinical characteristics and prognostic factors of delayed traumatic intracranial hematoma(DTIH). Method Clinical data of 66 patients with DTIH was analyzed retrospectively. Results DTIH often occurred within 72 hours after retardation head injury in the middle-aged and old men. It located most frequently in the frontotemporal site. Progressive deterioration of conciousness, gradual appearance of local neurological symptoms and focal epilepsy were the three main symptoms of DTIH, which was facilitated by hypotension. High mortality was usually seen in the patients over sixty, who suffered from severe primary brain injury (preoperative GCS>8), or whose DTIH was diagnosed over 24 hours following its occurrence. Conclusions DTIH has its distinct clinical characteristics. Serial CT scans may be helpful to making early diagnosis. The age of patients, severity of the brain injury, preoperative level of conciousness and DTIH diagnosis time were the main factors influencing the prognosis of the patients.

关 键 词：颅脑损伤 颅内血肿 迟发性血种 临床特点 DTIH 预后 

分 类 号：R651.15[医药卫生—外科学]