高原地区138例硬膜外血肿治疗疗效分析  

Plateau epidural hematoma treatment efficacy analysis 138 report attached

作　　者：魏林节[1] 冯国君[1] 吕国志[1] 董红让[1] 李在全[1] 叶东平[1] 李澜[1] 舒艳[1] 

机构地区：[1]中国人民解放军第一一五中心医院外一科,西藏86000

出　　处：《脑与神经疾病杂志》2015年第2期130-132,共3页Journal of Brain and Nervous Diseases

摘　　要：目的探讨高原地区脑创伤后硬膜外血肿手术治疗方法,提高临床治疗水平。方法分析本院2002年1月至2011年12月收治的138例头部硬膜外血肿患者,对比前期组与后期组手术治疗效果总结临床治疗方法。结果早期组头部硬膜外血肿62例,通过手术血肿清除后,前期组重新手术7例,重新手术率11.29%;患者最终死亡12例,死亡率率为19.35%,其中恢复良好37例,占59.68%。后期组头部硬膜外血肿76例,患者临床表现有双侧瞳孔不等大、颅内压增高致临床症状较重、中线移位大于0.5cm、血肿量大于50ml和脑组织博动差者将去除骨瓣,后期组再次手术2例,再次手术率2.63%;患者最终死亡4例,死亡率为5.26%,其中恢复良好59例,占77.63%。两组再次手术率、死亡率、恢复良好率有差异显著(P<0.05)。结论高原地区脑外伤后硬膜外血肿通过临床症状判断去骨瓣可以降低致死率、再次手术率和提高功能恢复良好率。Objective To investigate the plateau region of epidural hematoma surgical treatment after traumatic brain, to improve the level of clinical treatment.Methods From April 2008 to April 2012 the cerebrospinal fluid （ CSF ） cytology in 138 cases, CSFsamples from natural precipitation or slide centrifugal process piece, conventional step-grid-Giemsa staining was observed.Results From January 2002 to January 2006, 62 cases of epidural hematoma group （ early group） after removal hematoma, 7 cases surgery again,surgical rate was 11.29%;12 cases patients died,the mortality rate was 19.35%,37cases recovered well,accounted for 59.68%.from February 2006 to December 2011, 76 cases of epidural hematoma group （ late group ） , clinical manifestations had anisocoria, increased intracranial pressure, midline shift greater than 0.5cm, hematoma greater than 50ml or poor pollex brain would removed bone, 2 cases surgery again, surgical rate was 2.63%; patients died 4 cases, mortality was 5.26%;59 cases recovered well, accounting for 77.63%.Two groups surgical rate again, mortality and the rate of recovering well were significant difference（ P〈0.05） .Conclusion Epidural hematoma after traumatic brain in plateau area by removing part of bone flap can reduce fatality rate, surgical rate again and improve functional recovery rate.

关 键 词：硬膜外血肿 脑创伤 手术治疗 

分 类 号：R651.19[医药卫生—外科学]