骨瓣开颅血肿清创术治疗创伤性闭合性硬脑膜外血肿近期疗效观察  

Short-term effects of bone flap craniotomy and evacuation of hematoma on treating traumatic closed epidural hematoma

作　　者：温大平 崔健[1] 杭军[1] 

机构地区：[1]西安市第一医院神经外科,西安710002

出　　处：《中国实用神经疾病杂志》2016年第17期18-20,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨骨瓣开颅血肿清创术治疗创伤性闭合性硬脑膜外血肿近期临床效果。方法选取118例创伤性闭合性硬脑膜外血肿患者,分成对照组59例,予内窥镜血肿清除术,观察组59例,予骨瓣开颅血肿清创术,观察治疗后近期疗效。结果对照组治愈率低于观察组(P<0.05),病死率高于观察组(P<0.05);对照组感染、脑膜粘连发生率较观察组低(P<0.05),但再出血、癫痫、术后头晕头痛发生率较观察组高(P<0.05);观察组手术时间、术中出血量、平均血肿引流量、置管时间、住院时间均较对照组高(P均<0.05);2组术后3d、1个月、3个月GCS评分较治疗前均有所改善(P<0.05),但观察组改善效果优于对照组(P<0.05)。结论骨瓣开颅血肿清创术治疗创伤性闭合性硬脑膜外血肿后近期疗效总体良好。Objective To investigate short-term effects of bone flap craniotomy and evacuation of hematoma on treating traumatic closed epidural hematoma. Methods One hundred and eigteen cases with traumatic closed epidural hematoma were divided into control group （n= 59） receiving endoscopic evacuation of hematoma and observation group （n = 59） treated by bone flap craniotomy and evacuation of hematoma. The short-term efficacies of two groups were observed. Results The control group showed lower curative rate and higher mortality than the observation group （All P〈0.05） ;Compared with observation group, the control group had lower infection rate and occurrence rate of meningeal adhesion but higher re-bleeding rate, epilepsy, postoperative dizzy and headache rates （All P〈0.05）. The operation time,amount of blood loss,average hematoma drainage volume,catheter time and hospital stays in the observation group were higher than those in the control group （All P〈0.05） ;GCS scores 3d,one month and three months after treatment were improved in two groups,and the observation group showed superiority to the control group （P〈0.05）. Conclusion Short-term effects of bone flap craniotomy and evacuation of hematoma on treating traumatic closed epidural hematoma were favorable.

关 键 词：骨瓣开颅术 血肿清创术 创伤性闭合性硬脑膜外血肿 

分 类 号：R651.11[医药卫生—外科学]