硬膜外血肿穿颅清除术24例临床体会

Evacuation of the Extradural Hematoma by Transcranial Paracentesis in 24 Cases

目的 总结穿颅清除术治疗急性外伤性硬膜外血肿的临床体会。方法 回顾性分析24例急性外伤性硬膜外血肿实施选择性穿颅清除术的临床资料，采用弦距定位法确定穿刺点，选用颅内血肿粉碎穿刺针进行穿刺、抽吸、冲洗、粉碎、液化及引流。结果 本组平均治疗时间3．4（2—5）d，无一例再出血或死亡，亦无中转开颅手术，CT复查示血肿清除率达85％～95％，随访3～6个月，本组GOS评分均为良好。结论 选择性穿颅清除术治疗急性外伤性硬膜外血肿方法简易、有效、安全、经济，值得推广。

Objective To investigate the evacuation of the extradural hematoma by transcranial paracentesis. Method 24 cases of acute traumatic extradural hematoma underwent transcranial paracentesis were retrospectively reviewed. The hematoma was flushed, liquidized and drained. Results No conversion to open surgery, no rebleeding and death occurred. The hematoma was reduced in size by 85% to 95% according to CT. It showed good GOS score in 24 patients during 3 to 6 months follow-up. Conclusion Evacuation of the extradural hematoma by transcranial paracentesis is a simple, effective way to treat acute traumatic extradural hematoma.