外伤性颅内血肿开颅血肿清除术后迟发血肿相关因素研究  

Clinical Analysis on the Related Factors of Delayed Hematoma after Hematoma Evacuation in Traumatic Intracranial Hematoma

作　　者：章炬 Zhang Ju(Department of Neurosurgery, the First people＇s Hospital of L iangshan Yi Autonomous Prefecture, Sichuan 615000, China)

机构地区：[1]凉山彝族自治州第一人民医院神经外科,四川西昌615000

出　　处：《神经损伤与功能重建》2017年第4期369-370,376,共3页Neural Injury and Functional Reconstruction

基　　金：沧州市科技计划项目(No.162302035)

摘　　要：目的:探索外伤性颅内血肿开颅血肿清除术后迟发血肿发生的危险因素。方法:回顾性研究因急性外伤性颅内血肿来我神经外科行开颅手术治疗的患者297例,根据是否发生迟发血肿分为迟发血肿组(研究组)和非迟发血肿组(对照组),分析2组临床特征差异及迟发血肿的危险因素。结果:2组年龄、收缩压、血浆凝血酶原时间(PT)和部分活化凝血活酶时间(APTT)差异无统计学意义(P>0.05);血肿量、手术时间、格拉斯哥昏迷量表(GCS)评分、舒张压和血小板计数差异有统计学意义(P<0.05)。迟发血肿的危险因素有:手术时间、GCS评分、颅骨骨折、昏迷状态、APTT和舒张压。手术时间是迟发血肿的保护因素,颅骨骨折、APTT和GCS评分是迟发血肿的危险因素。结论:开颅手术治疗外伤性颅内血肿时,对入院时手术时间短,合并有颅骨骨折,PT显著延长及GCS评分较低的患者尤其要注意术后预防迟发血肿的发生。Objective： To explore the related factors of delayed hematoma after hematoma evacuation in trau- matic intracranial hematoma. Methods： Clinical data of 297 patients with acute traumatic intracranial hemato- ma who received surgical operation to remove intracranial hematoma was collected and analyzed. Cases were di- vided into experimental group （with delayed hematoma） and control group （without delayed hematoma）. The clinical difference and risk factors of two groups were compared. Results： There is no statistical significance lied in age, systolic blood pressure, plasma prothrombin time （PT） and activated clotting time （APTT） between two groups （P〉0.05）. But the hematoma volume, operation time, Glasgow coma scale （GCS） score, diastolic pres- sure and the blood platelet count in the two groups were statistically different （P〈0.05）. The risk factors for de- layed hematoma were the operation time, GCS score, skull fracture, coma, APTT and diastolic pressure. Opera- tion time was protection factor and skull fracture, APTT and GCS score were risk factors for delayed hematoma. Conclusion： For patients received surgical operation treatment for traumatic intracranial hematoma, we should pay more attention to those with shorter operation time, skull fracture, prolonged PT, and lower GCS score to pre- vent occurring of delayed hematoma after surgery.

关 键 词：外伤性颅内血肿 血肿清除 迟发性血肿 相关因素 临床研究 

分 类 号：R741[医药卫生—神经病学与精神病学] R651.1[医药卫生—临床医学]