摘要
目的探讨慢性硬脑膜下血肿的临床特点及其并发症的防治。方法回顾性分析82例患者的临床资料，总结单纯穿刺或钻孔引流与骨窗或骨瓣开颅血肿清除＋包膜切除治疗的效果及其并发症的防治。结果82例患者中，79例恢复良好，1例轻残，2例死亡。并发症有颅内积气6例，脑积液漏4例，低颅压头痛2例，血肿复发3例，癫痫发作1例。死亡2例中分别死于大面积脑梗死和肺部感染并心力衰竭。结论慢性硬膜下血肿多系轻微外伤造成，临床表现多以高颅压及意识障碍为主，CT及MRI可明确诊断。本组68例患者通过锥颅或钻孔引流治愈，14例（包括血肿复发3例）包膜增厚、钙化、多房分隔或血肿复发者可行骨窗或骨瓣开颅，清除血肿并切除包膜。
Objective To explore the clinical characteristics and prevention of postoperation in chronic subdural hematomas（CSDH）. Methods The clinical data of 82 patients with CSDH were anlyzed retrospectively. All cases were treated by surgery, including craniopuncture, skull boreing, bone flap of skull and Amiculumsectomy. Results Of all patients, 79 recovered well, 2 died, 1 was mildly disabled. The complication of postoperative was： pneumocephalus in six cases, cerebrospinal fluid fistulae in four cases, intraeranio - bypotensive headache in two cases, hematoma recidivation in three cases, epilepsy episode in one case. The two died cases been due to large size brain embolism and infection in lung complicated heart failure. Conclusions The most CSDH are related to little head injury. Main clinical manifestation is increased intracranial pressure and consciousness disturbance. The diagnosis can been acquired rapidly and smoothly by CT and MRI. 68 patients recoved well through bore drainading and eranipouncture. 14 cases （including 3 cases recidivatel） with amieulum thicker, calcification, muhifocal demarcation or hematoma recidivation are performed through bone flap of skull. Including evacuative of hematoma and amiculmsectomy.
出处
《中国实用医刊》
2009年第13期30-31,共2页
Chinese Journal of Practical Medicine
关键词
慢性硬膜下血肿
钻孔引流
包膜切除
并发症
Chronic subdural hematoma
Bore drainage
Amiculumsectomy
Complication
