摘要
目的 探讨外伤性迟发性硬膜外血肿（ＤＥＤＨ） 的发病规律、诊断及治疗。方法 经ＣＴ监测及临床观察确诊８４例ＤＥＤＨ， 分析迟发性血肿与原发损伤的关系及治疗资料。结果 经２ 次ＣＴ检查发现迟发性血肿７０ 例，经３ 次ＣＴ检查确诊１４ 例；迟发性血肿多发生于伤后２４ 小时内（６４－３％ ） ，多见于颞顶部（５９－５ ％） ，且多有颅骨骨折（７６－２％ ） 。下述情况的ＧＯＳⅣ～Ⅴ级者占比例最高，其中额颞部血肿（１８／２０） ，ＧＣＳ１３ ～１５ 分（５３／５３），血肿量５０ ｍＬ以下（５５／５５） ，手术清除血肿（４５／５４） ，提示具有这些情况的患者预后较好。结论 ＣＴ和颅内压（ＩＣＰ） 监测有助于及时发现ＤＥＤＨ 和确定正确治疗方案，对部分小血肿病人可行保守治疗。
Objective To explore the mechanism, diagnosis and treament of delayed onset of traumatic extradural hematoma (DEDH).Methods We analysed the relationship between DEDH and primary head injury and the treatment datum of 84 cases of DEDH defined by computed tomography (CT) monitoring, intracranial pressure (ICP) monitoring and clinical observation. Results 70 cases DEDH were found by preforming CT twice and 14 cases by performing CT 3 times. Most DEDE occured within 24 hours after injury (64.3%). Most of them, the lesion were located in temporal parietal lobe (59.5%) and the majority had skull fracture (76.2%). The proportions of GOS Ⅳ Ⅴ were higher in following condition:hematoma in frontal temporal lobe (18/20), GCS 13～15(53/53), the amount of hematoma <50 mL (55/55) and hematoma cleared away by operation (45/54), which suggest that prognosis may be rather well in the patients with above condition. Conclusions CT and ICP monitoring were helpful to early finding DEDH and defining the correct diagnosis and therapy.Some patients with small hematoma can be managed by conservative treatment.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
1999年第6期337-339,共3页
Chinese Journal of Nervous and Mental Diseases
关键词
迟发性硬膜外血肿
CT监测
颅内压监测
诊断
治疗
Delayed onset of traumatic extradural hematoma CT monitoring Intracranial pressure monitoring Diagnosis Therapy
