儿童外伤性幕上硬膜外血肿的治疗体会  

Experience in the treatment of traumatic supratentorial epidural hematoma in children

作　　者：叶云峰 叶桓 YE Yun-feng;YE Huan(The Children's Hospital of Anhui Province,Hefei 230051,Anhui)

机构地区：[1]安徽省儿童医院神经外科,安徽合肥230051

出　　处：《安徽卫生职业技术学院学报》2020年第3期47-48,50,共3页Journal of Anhui Health Vocational & Technical College

摘　　要：目的:儿童外伤性幕上硬膜外血肿的临床表现、治疗方式及预后与成人有很大区别,该文拟探讨其临床特点与手术指征的选择。方法:回顾性分析医院神经外科收治的221例儿童外伤性幕上硬膜外血肿患儿的临床资料,根据病情分为手术治疗组和保守治疗组,了解其临床及影像学特征、手术方式及预后特点,并用GOS评分对两组患儿进行预后分析,了解其不良预后的因素。结果:术前GCS评分、血肿体积、血肿厚度、中线偏移程度、瞳孔异常及是否合并颅内其它损伤是导致患者不良预后的独立影响因素。结论:儿童幕上硬膜外血肿病情变化快,进行性意识障碍、血肿体积及有无其他神经功能损伤是手术的重要指标,总体来说,儿童幕上硬膜外血肿的预后较好。Objective:The clinical manifestations,treatment methods and prognosis of Traumatic Supratentorial Epidural Hematoma in children are very different from that in adults.This paper intends to explore its clinical characteristics and the selection of surgical indications.Methods:Retrospective analysis was performed on the clinical data of 221 cases of children with Traumatic Supratentorial Epidural Hematoma admitted to neurosurgery,which were divided into the surgical treatment group and the non-surgical treatment group according to their conditions.Study its clinical and imaging characteristics,surgical methods,and prognostic characteristics,and to analyze the prognosis of the two groups using GOS scores to understand the factors of poor prognosis.Results:The preoperative GCS score,hematoma volu-me,hematoma thickness,midline shift degree,pupil abnormality,and whether it was associated with other intracranial injuries were the independent influencing factors leading to poor prognosis.Conclusion:Supratentorial epidural hematoma changes rapidly in children.Progressive disturbance of consciousness,hematoma volume,and presence or absence of other neurological impairments are important indicators of surgery.Overall,the prognosis of epidural hematoma in children is better.

关 键 词：硬膜外血肿 儿童 GOS评分 

分 类 号：R651.15[医药卫生—外科学]