摘要
目的 :探讨外伤性硬膜外血肿微创治疗的新方法及其疗效。 方法 :选择 5 6例经头颅CT确诊为外伤性硬膜外血肿患者 ,局麻下行颅骨钻孔 ,尽量吸除血肿降低颅内压 ,置引流管于血肿腔内 ,并固定于头皮上 ;术后复查头颅CT ,根据硬膜外残余血肿量 ,经引流管灌注尿激酶 3~ 5万单位 ,夹管保留 2h后开放引流 ,每天 1次 ;血肿基本清除后拔除引流管。 结果 :治疗 2~ 3天后患者头痛、呕吐症状消失 ,肢体麻木、偏瘫开始恢复 ;钻孔吸除加尿激酶溶解引流 3~ 4天 ,血肿基本清除 ,无继发出血、感染等并发症 ;格拉斯哥预后评分 (GOS) :5级 5 4例 ,4级 2例。 结论 :钻孔吸除加尿激酶溶解引流术是一种简便、微创、安全、有效的治疗外伤性硬膜外血肿的方法 。
Objectives:To investigate the results of a new minimally invasive method for the treatment of epidural hematoma. Methods:Fifty six patients with traumatic epidural hematoma were drilled and the hematomas were aspirated during operation. Simultaneous drainage tube was put into the hematoma cavity. Accordingly, 30 000~50 000 unit urokinase was perfused into the hematoma cavity. Two hours latter, drainage of liquefied hematoma was performed. Lysis and drainage of hematoma was done once per day. Residual epidural hematoma was estimated by postoperative skull CT. Results:Headache, vomiting, numbness and hemiplegia disappeared in 2~3 days of treatment. Skull CT showed that epidural hematoma disappeared in 3~4 day of drilling and drainage. There were no recurred hemorrhage or infection. According to GOS, the results were grade 5 in 54 cases, grade 4 in 2 cases. Conclusions:Direct cleaning by drilling combined with lysis and drainage of hematoma with urokinase is a simple, safe, effective and minimally invasive method and can take the place of traditional craniotomy in some suitable cases with traumatic epidural hematoma.
出处
《医学研究生学报》
CAS
2003年第7期513-514,517,共3页
Journal of Medical Postgraduates
基金
南京军区南京总医院科研基金资助项目 (批准号 :2 0 0 2 0 81)
关键词
外伤性硬膜外血肿
钻孔引流术
尿激酶
Traumatic epidural hematoma
Drilling and drainage
Urokinase