慢性硬膜下血肿分隔膜形成机制探讨  

Discussion on the Formation Mechanism of Dissepiment in Chronic Subdural Hematoma

作　　者：陶志强[1] 丁胜鸿[1] 陈相兵[1] 李剑伟[1] 朱志刚[1] 金志清[1] 

机构地区：[1]浙江省义乌市中心医院(温州医科大学附属义乌医院),322000

出　　处：《医学研究杂志》2014年第11期125-127,共3页Journal of Medical Research

基　　金：义乌市科技攻关项目(2012-G3-02)

摘　　要：目的探讨慢性硬膜下血肿分隔膜形成机制。方法收治的慢性硬膜下血肿手术患者35例,回顾性分析术前、术后的神经影像和术中观察资料。结果 14个患者中发现18个分隔膜。术前影像学发现6个,血肿复发第2次手术时发现内膜下积液而行膜切开2个,术后影像学新发现10个。术前影像学发现病例,只有1例术中见到分隔膜。术后出现的10个分隔膜均未处理,血肿未复发。结论慢性硬膜下血肿的分隔膜来自血肿内膜或外膜剥离,内膜剥离更为常见。有些分隔膜术中不易发现。头部再次创伤和外引流造成的负压可能是产生分隔膜的原因。Objective To investigate the bechanced mechanism of dissepiment of chronic subdural hematoma.Methods Thirty-five operative patients with chronic subdural hematoma of queuing admitted were retrospectively analyzed according to the nervous image and data of operative observation.Results Eighteen dissepiments were discovered in 14 patients.Sixteen dissepiments were discovered from the nervous image,six of them prior the operation and ten behind the operation.Collection of fluid under the inside membrane were drained in two recurred cases.In all of the patients,dissepiments which discovered from the nervous image was found at operation only in one case.We did not find recurred cases of CSDH in ten untreatment patients whose dissepiments discovered from the nervous image behind the operation.Conclusion Dissepiment comes from the inside or the outside membrane of the chronic subdural hematoma,and more commoner from the former.Some of the dissepiments cann＇t be found easily in the operation.Head wound again or the betrayal press in hematoma drainage process may be the causation which developing the dissepiments.

关 键 词：慢性硬膜下血肿 分隔膜 内膜剥离 外膜剥离 机制 

分 类 号：R651.11[医药卫生—外科学]