【摘要】 目的 探讨脑膜中动脉（MMA）栓塞预防超急性硬脑膜外血肿（HEDH）增大的有效性和安全性。方法 回顾性分析2021年3月至2023年3月高密市中医院神经外科MMA栓塞治疗的24例HEDH患者的临床资料（MMA组）。选取2019年3月至2021年3月保守治疗的26例HEDH为对照组。伤后24 h复查CT显示血肿量大于伤后初次CT显示血肿量的50%即为血肿增大。结果 伤后24 h,MMA组复查CT显示血肿体积为11～29 mL，中位数14(11～17)mL；其中3例出现血肿增大，发生率为12.5%，均未行开颅手术治疗。对照组伤后24 h复查头部CT显示血肿体积为10～72 mL，中位数17(14～24)mL，血肿增大11例，发生率为42.3%，其中6例行开颅血肿清除术。MMA组血肿增大发生率明显低于对照组（χ~2=5.500,P=0.028）。结论 血肿侧MMA栓塞可以有效控制HEDH进展，减少血肿增大的风险，能够有效降低患者开颅手术率。更多还原

【Abstract】 Objective To investigate the efficacy and safety of middle meningeal artery(MMA) embolization in preventing the enlargement of hyperacute epidural hematoma(HEDH). Methods The clinical data of 24 patients with HEDH who underwent MMA embolization in the Department of Neurosurgery, Gaomi Traditional Chinese Medicine Hospital, Shandong Province from March 2021 to March 2023 were retrospectively analyzed(MMA group). A total of 26 patients with HEDH who received conservative treatment from March 2019 to March 2021 were selected as the control group. Hematoma enlargement was defined as a hematoma volume on CT reexamination at 24 hours after injury that was >50% larger than that on the initial CT scan after injury. Results At 24 hours after injury, CT reexamination in the MMA group showed that the hematoma volume ranged from 11 to 29 mL, with a median of 14(11～17) mL. Among them, 3 cases(12.5%) showed hematoma enlargement, and none underwent craniotomy. In the control group, CT reexamination at 24 hours after injury showed that the hematoma volume ranged from 10 to 72 mL, with a median of 17(14～24) mL. Hematoma enlargement occurred in 11 cases(42.3%), of which 6 underwent craniotomy for hematoma evacuation. The incidence of hematoma enlargement in the MMA group was significantly lower than that in the control group(χ~2=5.500, P=0.028). Conclusion MMA embolization on the hematoma side can effectively control the progression of HEDH, reduce the risk of hematoma enlargement, and significantly decrease the rate of craniotomy in patients.更多还原