急性外伤性颅内血肿的近代诊断和治疗

RECENT ADVANCES IN DIAGNOSIS AND TREATMENT OF ACUTE TRAUMATIC INTRACRANIAL HEMATOMA

总结CT诊断后治疗的外伤性颅内血肿348例,总死亡率为9.5％,明显低于CT使用前国内大宗统计的26.16％。硬膜外血肿107例全部治愈,全组伤情较轻的54例非手术治愈。CT对过去易漏诊的较小血肿、深部血肿、脑室血肿、多发血肿等均能显示,使血肿的诊出率从占住院的颅脑损伤的8％～15％增至31.2％。CT复查能准确了解血肿的进展、稳定、消退或迟发等情况。动态观察CT并与临床变化相结合,才能正确选择血肿的手术适应症和时机,提高疗效。

348 cases of acute traumatic intractanial hematoma were treated after CT scaned verification. The total mortatity was 9.5%. Which was evidently less than the value (26.16%) found before using CT in our country in a big survey. 107 epidural hematoma was all cured. 54 cases of milder condition was-cured by non-operative treatment. Hematoma which were small or deep were ventricular or multiple, which was very difficultly for diagnosis could also be shown by CT. The diagnosive rate of hematomas increased from 8%～15% to 31.2%. Repeated CT could find out the expansion or stability of hematoma, and also absorbed and delayed hematoma. Only by critical obsevation on both CT and clinical changes one could fred out the indication and opportunity of operation and increase the efficiency of treatment.