外伤性硬膜下积液198例临床分析

A Report of 198 Cases of Subdural Hydroma due to Traumatic Head Injury

目的:探讨外伤性硬膜下积液发病机理、治疗方式及指征。方法:总结采用不同方法治疗的198例患者临床表现, CT等影像学特征,腰穿测压结果等临床资料。结果:保守治疗治愈137例,复查CT积液于3周至4月内完全消失122例,明显减少15例;另61例症状加重,CT显示积液量增多者转手术治疗,均痊愈。结论:提出动态CT复查及密切临床观察下保守治疗及手术治疗的指征及方式,对于合理治疗,降低手术率,缩短病程,提高疗效有重要意义。

Objective: To investigate the contributing factors, therapeutical modes and indications of subdural hydroma due to traumatic head injury. Methods: 198 cases of this conditions were summarized and their computerized tomography, lumber drainage pressure and clinical manifestations were analyzed. Results: 137 cases received conventional drug therapy and were cured, subdural hydroma disappeared in 122 cases, and apparently decreased in 15 cases by followed-up for 3 weeks to 4 months; and the other 61 cases deteriorated and hydroma increased were subjected into operation, eventually cured. Conclusion: Timely reexamination of CT and closely observation of clinical signs were important for choosing conventional drug therapy or operation and essential for reasonable therapy, dereasing mortality, shortening hospitalization and elevating therapeutic effects in these patients.