摘要
目的探讨颅脑外伤术后进展性硬脑膜外血肿（TPEDH）的临床特点和早期诊治方法。方法对34例颅脑外伤术后TPEDH的资料进行回顾性分析，对其临床表现、CT检查结果、治疗结果进行总结。结果本组34例TPEDH中，邻近型8例，远隔型26例；单侧者30例，双侧4例；以颞顶部和枕顶部最多见。主要表现为术后意识障碍无明显好转或者出现新的神经功能障碍表现。再手术33例，32例确认血肿处骨折存在。出院时GOS评分5分12例，4分8例，3分6例，1分8例。结论术后TPEDH多见于冲击部位，早期CT复查有助于及时诊断和改善预后。
Objective To evaluate the methods for early diagnosis and treatment of traumatic progressive epidural hematoma （TPEDH）. Methods Thirty-four eases of TPEDH were reviewed retrospectively. Its clinical manifestations, results of CT scanning and outcome were analyzed. Results Among the 34 cases, adjacent type was in 8 patients and removed type in 26. TPEDH was located unilaterally in 30 eases and bi- laterally in 4. Most of TPEDH were located perieto-temporal and perieto-occipital region. Dominating manifestations were no-improvement of unconsciousness or appearance of new neuro-dysfucntion after initial craniotomy： Second operation was made in 33 cases and skull fracture was found in 32 cases beneath TPEDH. According Glasgow Outcome Scale（COS） , scores of 5,4,3 and 1 was experienced in 12,8,6 and 8 patients respectively on discharge. Conclusions TPEDH following initial craniotomy occurred in impact position in most cases. Early repeated CT scanning contributed to early diagnosis of DTEDH and improve the outcome.
出处
《国际外科学杂志》
2007年第12期815-818,共4页
International Journal of Surgery
