外伤性硬膜下积液演变为慢性硬膜下血肿的临床探讨（附17例报告）

clinical study of shock vulneralis with membrane effusion （ with 17 report ）

目的探讨外伤性硬膜下积液（TSE）演变为慢性硬膜下血肿（CSDH）的机制、临床特点及治疗方法。方法回顾性分析我院17例由TSE演变成CSDH的临床资料及有关文献资料。结果本组13．2％TSE演变成CSDH。患者均有明确头部外伤史，演变成血肿的时间为伤后24～128d。全部患者演变成CSDH时有不同临床表现，所有患者均经钻颅血肿引流术治愈。结论外伤性硬膜下积液演变为慢性硬膜下血肿以老年人多见，原发脑损伤较轻。发生机制可能是不断增多的积液导致桥静脉及蛛网膜粒破裂出血，血液与硬膜下积液混合，积液中纤维蛋白溶解亢进出现凝血功能障碍，使出血不止而形成慢性血肿。对TSE患者应行动态观察颅脑CT或MRI，警惕其演变成CSDH。

Objective： To study the shock vulneralis with membrane effusion , clinical characteristic and cure. Methods： Analysis of our hospital tremendously from 17 cases tse becoming csdh the clinical data and relevant documents. Results： 13. 2% tse becoming csdh. patients have a clear head trauma and evolve hematoma time for the 24 - 128 d. all the patients into a different clinical csdh, All patients are the way to cure hematoma art. Conclusion： the membrane hard up for the development of chronic hard to see the hematoma the primary cause brain impairment, more than light, a mechanism might be a sap is rising in the vein and an arachnoid membrane of a bleeding, the blood and hard to mix up the next level, fluids fibrinolysis in the blood and blood to more than a chronic hematoma. Tse patients should do is to observe ct and mri, they evolve csdh.