外伤性基底节区血肿的诊断和治疗

Diagnosis and treatment of traumatic basal ganglia hematomas

目的探讨外伤性基底节区血肿的发病机制、临床特点、诊断与鉴别诊断、治疗和结果。方法回顾性分析90例外伤性基底节区血肿病人的临床资料。结果手术治疗50例,保守治疗40例,1例患者治疗过程中放弃治疗出院,1例入院后1月内死亡。在伤后6个月根据GOS评分:死亡9例,植物生存8例,重残11例,中残26例,良好34例。结论外伤性基底节区血肿发病率较低而致死率和致残率较高,外伤性基底节区血肿早期CT检查,正确诊断和积极而恰当的治疗是改善预后的关键。

Objective To study the pathogenesis, clinicalc characteristic, diagnosis and differential diagnosis, treatment and outcome in patients with traumatic basal ganglia hematomas （TBGH）. Methods A retrospective analysis of 90 patients with TBGH was performed. Results Surreal treatment was achieved in 50 patients and conservative treatment in 40 patients. I cases abandoned treatment and discharged and 1 cases died within 1 month after admission. Final outcome in patients were graded at 6 months post - injury was classified according to GOS categories： death, vegetative being, severe disability, moderate disability and good recovery were obtained in 9 eases, 8 cases, 11 cases, 26 cases and 34 cases. Conclusion The incidence of TBGH is low, but the mortality and morbidity rates are high. The key to improve the prognosis is due to the early CT examination, correct diagnosis, a positive and appropriate treatment.