急性颅脑损伤术后致对侧迟发血肿的预测分析

PREDICTION AND MANAGEMENT OF CONTRA-LATERAL DELAYED HEMATOMA REMOTE FROM THE SITE OF INITIAL NEUROSURGICAL PROCEDURE OF ACUTE CRANIOCEREBRAL INJURY

目的 探讨急性脑外伤血肿清除术中及术后 ,继发对侧迟发性血肿发生的可预测因素及早期诊治要点。方法 对 19例在术中及术后继发对侧迟发血肿的病人 ,就其致伤原因、致伤部位与迟发血肿部位 ,原发血肿清除与迟发血肿形成的关系 ,临床特点与治疗结果进行分析。结果 19例对侧迟发血肿病人均行血肿清除手术 ,其中 5例死亡 ,手术死亡率为 2 6 3%。结论 急性颅脑外伤血肿清除术中及术后继发对侧迟发性血肿形成存在可预测性因素和明显临床特点 。

Objective\ To investigate the predictable factors and early management of contra-lateral delayed hematoma after initial neurosurgical procedure of acute craniocerebral injury. Methods\ 19 patients with intra-and postoperative delayed contra-lateral intracranial hematoma were studied. All the factors were analyzed including the traumatic causes, the sites of initial injury and the delayed hematoma, the correlated factors between acute intracranial hematoma evacuation and contral-lateral delayed hematoma formation, the clinical characteristics and outcomes. Results\ All the contral-lateral delayed hematomas were removed by surgery in 19 patients and 5 patients died after surgery. The operative mortality was 26.3%. Conclusion\ There are predictable factors of pre-operation and significant clinical characteristics for patients with contral-lateral delayed hematoma remote from the site of initial neurosurgical procedure of acute craniocerebral injury.It may improve the outcome to make pre-operation predication and early management.