外伤性颅内血肿清除术后继发迟发性血肿临床分析

CLINICAL ANALYSIS OF THE POSTOPERATIVE DELAYED INTRACRANIAL HEMATOMA OF THE CEREBRAL INJURY CAUSED INTRACRAMIAL HEMATOMA

目的:探讨急性外伤性颅内血肿清除术后,如何及时发现颅内迟发性血肿并及时处理、提高疗效。方法:对25例颅内血肿清除术后有瞳孔和意识改变的患者及时行CT检查。结果:CT检查后均发现迟发性颅内血肿,再次手术清除颅内血肿18例,保守治疗7例,治愈11例,轻残3例,重残3例。植物生存4例,死亡4例。结论:对首次CT提示颅内血肿伴脑挫裂伤或小出血灶、术后病情有变化者应考虑有迟发性颅内血肿形成,宜动态复查CT,早诊早治以改善预后。

Objective： To improve the curative effect of cerebral injury by diagnosing and treating postoperative delayed intracranial hematoma timely after removal of acute intracranial hematoma.Methods： 25 patients with change of pupil and consiousness received CT brain scan promptly after removal of intracranial hematoma. Delayed intracranial hematoma had been discovered in all of these patlents.Results： An cases underwent removal of intracranial hematoma for the second time , 7 case received conservative treatment, 11 cases acquired complete rehabilitation, 2 cases survived only as vegetables, and 4 cases died. Conclusion： The postoperative delayed intracranial hematoma is related to disturbance of cerebrovascular constriction and dialatation , as well as change in intracranial pressure, Delayed intracranial hematoma should be considerecl in the patients with intracranial hematoma accompanied by cerebral injury or tiny hemorrhagic spots found the in first image of CT scan, and especially in patients whose postoperative condition deteriorated. Application an CT series in these patients is necessary which is better for early diagnosis and management and can improve their prognosis greatly.