硬膜外血肿非手术治疗30例报告

NONSURGICAL MANAGEMENT OF EXTRADURAL:HEMATOMAS:A REPORT OF THIRTY CASES

报道３０例外伤性硬膜外血肿，入院时仅有轻微神经症状、无脑疝体征，经非手术治愈。复查ＣＴ显示伤后１月内血肿部分吸收，超过１月血肿完全吸收。讨论了影响非手术治疗的因素，适应症为：在神志清楚，无明显神经定位体征，临床情况逐渐好转前提下，①血肿幕上＜５０ｍｌ，幕下＜１５ｍｌ；②血肿非局限于颞部；③血肿基底宽而簿。

Nonsurgical treatment of a series of 30 patients with traumatic extradural hamatomas that were not evacuated surgically is presented.All the patients had only minimal neurological symptoms and no signs of brain herenintion on admission. In all cases, the extradural hematomas were healed conservatively 14 patients were followed by serial CT scanning. Of them, 6 patients showed the partial resolution of the hematomas within 1 month of postinjury, and 8 patrents showed the complete resolution over 1 month of postinjury. Factors that influence outcome of nonsurgical treatment include the level of coniousness, the size, the location, and the configuration of the clot, and presence of associated intradural lesions.These factors, and the indication of nonsurgical treatment are discussed.