颅后窝血肿的治疗

Treatment Experience of Posterior Cranial Fossa Hematoma in 39 Cases

目的 评价 3 9例颅后窝血肿的治疗方法及效果。方法 3 9例颅后窝血肿分别采用保守治疗、枕部开瓣术、微创碎吸术。结果 保守治疗 1 5例 ,死亡 1例 ;枕后开瓣治疗 1 0例 ,死亡 2例 ;微创碎吸治疗 1 4例 ,无 1例死亡。结论 对于颅后窝血肿量 >1 0mL ,且Ⅳ脑室完全阻塞 ,横窦骑跨性血肿 ,均采用枕部开瓣术 ,治疗效果好。对于生命体征平稳 ,血肿量 >1 0mL ,Ⅳ脑室部分受压但未完全闭塞 ,采用微创碎吸术治疗效果良好。对于生命体不平稳 ,血肿量大或脑损伤重者 ,采用开颅清除血肿及坏死脑组织 ,咬除枕骨 ,枕下减压术 ,因病情重 ,疗效差。

Objective To assess the treatment methods and effects of posterior cranial fossa hematoma in 39 cases. Methods The conservative treatment, operation, occipital opening, micro-suction were performed in 39 cases. Results 1 was died in 15 cases conservative treatment. 2 were died in 10 occipital opening and no dead in 14 micro-suction. Conclusion The occipital opening was better for hematoma that more than 10ml with complete obstruction of 4th ventricle and lateral sinus. The micro-suction was better for non-obstructed 4th ventricle. The normal operation was for unstable vital sign and large hematoma.