迟发性外伤性颅内血肿23例临床分析

Clinical analysis of delayed traumatic intracranial hematoma:Report of 23 cases

目的:探讨如何及时发现迟发性外伤性颅内血肿及其发病原因、诊断治疗和预防措施。方法:23例迟发性外伤性颅内血肿患者,血肿清除加去骨瓣减压12例,显微镜下小骨窗清除血肿5例,保守治疗6例。结果:23例中,恢复良好7例,仅能生活自理9例,植物生存状态1例,病死6例。结论:迟发性外伤性颅内血肿的发生同外伤部位、脑挫裂伤、颅骨骨折等因素有关,过量脱水、手术减压、凝血功能异常是诱因。及时诊断和治疗是降低迟发性外伤性颅内血肿的病死率和致残率的关键。

Objective：To investigate the clinical features and treatment of delayed traumatic intracranial hematoma（DTICH）.Methods：Twenty-three cases of DTICH were included in the study.The hemotoma in 12 cases were removed and decompressed by crinial bone resection and 5 cases were removed by means of craniotomy with small bone window resection under microscope.6 cases received expectant treatment.Results：Of the 23 patients with DTICH,7 were cured,9 could take care of themselves,1 was in vegetative state and 6 died.Conclusions：Position of the trauma,skull fracture,cerebral contusion and laceration are the factors related to delayed traumatic intracranial hematoma.Early diagnosis and treatment is key to successful treatment of patients with DTICH.