硬膜外血肿50例临床预后分析

Surgical Management of Traumatic Epidural Hematoma in 50 Cases with Dynamic CT Study

目的:报道50例在动态CT监测下手术治疗的创伤性硬膜外血肿病例,并对CT监测及其他相关指标与患者预后进行了分析。方法:回顾性分析手术治疗创伤性硬膜外血肿50例,治疗结果疗效评价在患者出院后12个月按格拉斯哥后果评分进行评定;入院时CT检查的血肿类型、中线移位与否和入院时GCS评分分组分析。结果:治愈及明显好转34例,重残10例,死亡6例(12%);入院时CT检查的血肿类型(P=0.002)、中线移位与否(P=0.041)和入院时GCS评分(P<0.001)等均与预后相关。结论:本研究的三种因素在创伤性硬膜外血肿的治疗中须引起重视;临床上应争取合并损伤出现之前及时手术治疗。

Objective：The present study is to introduce the clinical outcome of surgical management of traumatic epidural hamatoma in 50 cases,and the prognostic factors are also analysed.Methods：50 cases suffering from traumatic epidural hematoma were analyzed retrospectively,clinical outcome was evaluated according to Glasgow Outcome Scale（GOS）,patients were grouped by age,time interval from head injury to operation,CT scanning at admission,midline shift on CT examination and Glasgow Coma Scale（GCS）,Chi-square was rendered to investigate the prognostic factors.Results：Good results in 34 patients,severe impaired in 10 cases,dead in 6 cases.Statistic results demonstrated age（P=0.038）,time interval from head injury to operation（P=0.010）,CT scanning at admission（P=0.002）,midline shift on CT examination（P=0.041）and GCS（P＆lt;0.001）were all the prognostic factors for the outcome in patients with traumatic epidural hematomas.Conclusion：Great attention should be payed at traumatic epidural hematoma patients on CT scanning at admission,midline shift on CT examination and GCS.Surgical intervention must be performed before complications developed.