外伤性迟发性颅内血肿72例临床分析

Clinical analysis of 72 cases of delayed traumatic intracerebral hematoma

目的 分析外伤性迟发性颅内血肿发生的相关因素及探讨处理方法，提高早期预防和治疗水平。方法 回顾分析了我科近3年收治的72例外伤性迟发性颅内血肿病例，其中因症状加重进行复查cT52例，主动性复查20例。结果 本组行手术治疗34例，死亡率12．5％，保守治疗38例，保守治疗无死亡，重残和轻残者均为手术组病人。结论 外伤性迟发性颅内血肿与是否存在颅骨骨折、早期强力脱水、对冲伤损伤程度有关。对存在外伤性迟发性颅内血肿危险因素的患者，应在外伤后6—9h内复查头颅CT，一旦确诊，应予相应处理。

Objective To analyse the factors of what caused delayed traumatic intracerebral hematoma and explore the management, and improve the ability of early prevention and treatment. Methods A retrospective analysis was made for 72 cases of delayed traumatic intracerebral hematoma at our department in recent 3 years. Among them,52 ca- ses were examined with CT because the symptoms became worse, and 20 cases were examined actively. Results Thirty - four cases were treated with operation, 12.5% of them were dead,the others without operation were alive and all dis- ability occurred after operation. Conclusions Delayed traumatic intracerebral hematoma has relationship with skull fracture, dehydration early, extent of contracoup injury. The patients who have the dangerous factors of delayed traumatic intracerebral hematoma should be re - checked with CT of the brain between 6 and 9 hours after injury. Once diagnosed clearly, the patients should be treated in time.