1082例急性创伤性颅内血肿救治与预后

Clinical analysis on 1 082 cases of acute traumatic intracranial hematoma

目的总结急性创伤性颅内血肿诊治经验,分析影响预后的因素,提高其治疗水平。方法统计1990-03～2002-03收治的急性创伤性颅内血肿总数,对其发生率及治疗效果进行回顾性分析。结果经CT和手术证实的急性创伤性颅内血肿1082例,其中硬膜外血肿425例(39.3%),硬膜下血肿316例(29.2%),脑内血肿341例(31.5%)。手术治疗721例(66.6%),死亡190例(26.4%);非手术治疗361例(33.4%),死亡11例(3.0%)。全组硬膜下血肿病死率为27.5%(87/316),脑内血肿为20.2%(63/341),硬膜外血肿为10.6%(45/425),总病死率为18.6%(201/1082)。结论急性创伤性颅内血肿的预后与病人年龄、GCS评分、血肿大小及类型、瞳孔改变等相关。早期诊断和早期治疗,可降低其病死率。

Objective To summarize the diagnosis and treatment experience of acute traumatic intracranial hematoma, analyse the factors impacting prognosis in order to improve their therapeutic effects. Methods From 1990 to 2002, 1 082 cases of acute traumatic intracranial hematoma were retrospectively studied on the etiology, therapeutic effect; incidence and mortality. Results Of the 1 082 cases confirmed by CT and operation, 201 (18.6%) died. Among them, 10.6%(45/425) died of acute extradural hematoma; 27.5%(87/316) died of acute subdural hematoma; 20.2%(63/341) died of intracerebral hematoma. The mortality was 26.4%(190/721) in operation group and 3.0%(11/361) in non-operation group respectively. Conclusion Acute traumatic intracranial hematoma must be have relation with age, GCS scores, size and type of hematoma and pupillary change. The mortality would be reduced, if early diagnosis and treatment have been made.