颅脑创伤开颅术中、术后对侧迟发性硬膜外血肿诊治探讨(附26例分析)

Discuss of the diagnosis and treatment of contralateral delayed epidural hematoma in and after the operation of traumatic brain injury: reports of 26 cases

目的探讨颅脑创伤开颅术中、术后对侧迟发性硬膜外血肿的发生机制与处理方法。方法分析2008-01—2014-04颅脑创伤开颅术中、术后发生对侧迟发性硬膜外血肿26例患者的临床资料。结果随访3-6个月,按格拉斯哥预后评分（GOS）判定预后,恢复良好15例,轻残4例,重残2例,植物生存1例,死亡4例。结论颅脑创伤开颅术前应仔细研究患者的受伤机制,分析影像学资料,及时诊断并处理对侧迟发性硬膜外血肿,能提高其治愈率,减少死残率,改善患者预后。

Objective To discuss the occurring mechanism and therapeutic method of contralateral delayed epidural hematoma （ DEDH） in and after traumatic brain injury .Methods The clinical and radiological data and outcome of 26 patients were reviewed retrospec-tively between January ,2008 and January 2014.Results All the patients were followed up in 3-6 months after discharge and were analyzed the prognosis according the Glasgow Outcome Scale （ GOS） .There were 15 cases in Low disability , 4 in Moderate disability ,2 in Severe disa-bility,1 in Persistent vegetative state and 4 in Death.Conclusion The brain injury mechanisms and radiological datas of the patients should be deliberately analyzed before the brain surgery and early diagnosis and evacuation of the contralateral epidural hematoma may contribute to im -provement of its cure rate and prognosis , decrease of the death and disability .