摘要
目的 分析急性硬膜外血肿伴漩涡征患者的临床特征及预后.方法 选择36例CT平扫显示有“漩涡征”的急性硬膜外血肿患者为观察组,选择同时间段无“漩涡征”急性硬膜外血肿患者50例为对照组,均接受手术治疗.比较两组格拉斯哥昏迷评分（GCS）、血肿出血量及预后情况.结果 观察组入院GCS评分、术前GCS评分、术前CT评估出血量、术中测量出血量分别为（10.6±2.3）分、（8.3±2.5）分、（56.4±8.7）mL、（63.2±9.8）mL,对照组分别为（10.2±2.7）分、（9.9±2.6）分、（52.8±7.9）mL、（53.2±7.2）mL,两组入院GCS评分、术前CT评估出血量差异均无统计学意义（均P＞0.05）,两组术前GCS评分、术中测量出血量差异均有统计学意义（t=3.232、3.164,均P＜0.05）.观察组死亡11例,病死率为30.5％;对照组死亡6例,病死率为12.0％ （6/50）,两组病死率差异有统计学意义（χ^2=4.134,P＜0.05）.随访6个月,观察组日常生活活动能力评分优良率为64.0％,显著低于对照组的84.1％,差异有统计学意义（χ^2=3.989,P＜0.05）.结论 伴“漩涡征”急性硬膜外血肿患者病情呈进行性加重,患者病死率高,预后差,应该采取积极的应对措施.
Objective To analyze the clinical features and prognosis of patients with acute epidural hematoma in the whirlpool sign.Methods 36 cases of CT scan showed a ＂whirlpool sign＂ of acute subdural hematoma patients were selected as the observation group.During the same time period,50 acute epidural hematoma patients without the ＂whirlpool sign＂ were selected as the control group.All patients received operation treatment.The Glasgow coma score （GCS）,amount of hemorrhage and prognosis were compared between the two groups.Results The preoperative GCS score of the observation group was significantly lower than that of the control group （P 〈 0.05）.In the operation,the blood loss of the observation group was significantly increased compared with the control group （t =3.232,3.164,P 〈 0.05）.Control group CT evaluation of preoperative and intraoperative measurement had no significant difference（P 〉0.05）.In the observation group,11 patients died,the mortality rate was 30.5% （11/36）.In the control group,6 patients died,the mortality rate was 12.0% （6/50）,the difference between the two groups was statistically significant （χ^2=4.134,P 〈 0.05）.The patients were followed up for 6 months,the excellent and good rate of ADL score in observation group was 64.0%,which was significantly lower than 84.1% in the control group （χ^2=3.989,P 〈 0.05）.Conclusion Acute epidural hematoma patients with the ＂ whirlpool sign ＂ showed progressive disease,high mortality,poor prognosis,and active countermeasures should be taken.
出处
《中国基层医药》
CAS
2015年第2期169-171,共3页
Chinese Journal of Primary Medicine and Pharmacy
关键词
硬膜外血肿
漩涡征
脑外伤
出血量
神经功能
Epidural hematoma
Whirlpool sign
Brain trauma
Hemorrhage
Nerve function
