锥颅穿刺置管引流治疗稳定型硬膜外血肿的临床分析

Clinical analysis on skull puncture catheter drainage on stable epidural hematoma

目的探讨锥颅穿刺治疗稳定型硬膜外血肿的疗效及适应证。方法 48例患者动态复查头颅CT示硬膜外血肿出血稳定后,局麻下行硬膜外血肿锥颅穿刺置管引流术,术后予以尿激酶5万U+0.9%氯化钠注射液3 mL注入,并夹闭2 h后放开引流,每天2次。结果术后48例患者的症状均明显缓解。复查头颅CT示,血肿完全消失42例,少量残留6例,无发生再出血;手术效果良好。结论锥颅穿刺置管引流治疗稳定型硬膜外血肿的疗效确切,损伤小,安全可靠。

Objective To explore the clinical efficacy and applicability of skull puncture treatment on the stable epidural hematoma. Method 48 patients with epidural hematoma accepted repeated head CT scan till the epidural hematoma turned stable,and perform skull puncture catheterzation under local anesthesia for subsequent drainage.When the operations were completed,patients were all given injection with fifty thousand U of urokinase with 3 mL of 0. 9% sodium chloride and two hours＇ clipping,after which drainage was taken twice a day. Results 48 patients got significantly eased,of whom 42 got dramatical cure according to the Head CT reexamination. 6 patients,despite minimal residue,also got excellent efficacy of no hemorrhage. Conclusion The skull puncture treatment with postoperative drainage has an exact advantage of less damage and safe efficacy on treating the stable epidural hematoma.