小儿创伤性硬膜外血肿致伤原因及临床特点(附114例分析)

The causes and clinical characteristics of 114 children with traumatic extradural hematoma

目的:分析小儿创伤性硬膜外血肿(EDH)的流行病学特点和临床特征。方法:收集小儿EDH的临床资料,根据其CT检查结果分为单纯型硬膜外血肿(SEDH)和复合型硬膜外血肿(CEDH),分析其在年龄、性别、受伤原因、手术和预后的流行病学特点和临床特征。结果:114例患者资料纳入研究,两组年龄构成差异有统计学意义,<3岁多见SEDH,≥3岁多见CEDH。男女比例为1.5∶1,两组性别构成差异无统计学意义;受伤原因比较差异有统计学意义,SEDH组最常见的是坠落伤,CEDH组以车祸伤和摔伤最常见,受伤原因在年龄分层研究上也有不同的特点。入院时GCS评分SEDH组高于CEDH组,SEDH组有70.8%评分在12分以上。中间清醒期SEDH组4.2%,CEDH组7.6%。出院时NHISS评分和病死率SEDH组均好于CEDH组。结论:小儿EDH有独特的流行病学特点和临床特征,外科医师需要密切关注以避免漏诊和误诊。

Objective： To analyze the epidemiological and clinical characteristics of the traumatic extradural hematoma in children. Methods： Clinical date of the children with traumatic extradural hematoma was collected. Based on the CT imaging, the patients were divided into two groups （simple extradural hematoma SEDH and com-plex extradural hematoma CEDH） to help study for the epidemiological and clinical characteristics of the age, gen-der, cause of injury, operation and prognosis et al. Results： One hundred and fourteen children^ clinical date were analyzed. More children less than 3 years old belong to SEDH and more over 3 years old belong to CEDH group. There was no difference in gender （male vs female = 1. 5 ： 1）. The most common cause of the injurys in SEDH was falling, and in CEDH were accident events and slipping. The causes of injury were also different in age stratified studies. The GCS of SEDH, 70. 8% of them superior to 12 scale, was higher than CEDH. The rate of lucid interval in SEDH was 4. 2% while in CEDH was 7. 6%. For the NHISS and the mortality, SEDH were superior to CEDH. Conclusion ： Neurosurgeons should be concerned to the epidemiological and clinical characteristics of the traumatic ex-tradural hematoma in children to avoid delaying diagnosis and treatment .