摘要
目的探讨急性硬膜下血肿减压后对侧硬膜外再出血的防治措施。方法分析31例急诊行急性硬膜下血肿减压术后对侧硬膜外再出血、再次行硬膜外血肿清除术患者的再出血时机及出院时格拉斯哥预后评分(GOS)。结果31例患者中5例(16.12%)因减压术中脑膨出发生再出血,13例(41.93%)因术后观察到脑压增高发生再出血,7例(22.58%)术后定期复查CT发生再出血,6例(19.35%)因发现对侧瞳孔散大后才发现再出血;出院时行GOS评分:恢复良好及轻度残疾者17例(54.83%),重残、植物状态生存及死亡14例(45.16%)。结论术前充分评估,做好再出血手术预案;术中、术后密切观察脑压;及早发现硬膜外再出血征象是硬膜下血肿减压后对侧硬膜外再出血防治的关键。
Objective To summarize the experience of diagnosis and treatment for the patients with contralateral recurrent epidural hemorrhage after subdural decompression operation. Methods A retrospective analysis of the diagno- sis, treatment and prognosis for 31 patients with contralateral recurrent epidural hemorrhage after subdural decompres- sion operation in our hospital from January 2008 to January 2013 was assessed. Results Contralateral recurrent epidural hemorrhage were observed in 5 patients （16.12%） during the decompression operation, in 13 patients （16.12%） by in- tracranial pressure monitoring, in 6 patients （16.12%） through periodic CT scanning, in 6 patients （19.35%） with my- driasis. In the patients with treatment, 17 patients （54. 83 %） recovered well or suffered from mild disabler while in the other 14 patients （45.16%） the prognosis was poor. Conclusion Preoperative evaluation, drafting the surgical plan and postoperative ICP monitoring improve the prognosis of the patients with contralateral recurrent epidural hemorrhage.
出处
《西部医学》
2013年第12期1821-1822,1825,共3页
Medical Journal of West China
关键词
硬膜外血肿
硬膜下血肿
减压手术
Epidural hemorrhage
Subdural hemorrhage
Decompression operation
