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影响急性外伤性硬脑膜外血肿疗效的相关因素分析(附484例报告)

Analyse is of the Factors Related to Curative Effects on Acute Traumatic Epidural Hematomas

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【作者】 王保华惠国桢裴永恩戴学元周滨音吴星郜宪礼李晓明饶斌查昀

【Author】 WANG Bao-hua, HUI Guo-zhen, PEI Yong-en, et al . Department of Neurosurgery, The 5th Hospital of Huangshi, Huangshi Hubei 435005, China

【机构】 黄石市第五医院神经外科苏州大学附属第一医院神经外科黄石市中心医院神经外科黄石市第五医院神经外科 湖北黄石435005江苏苏州215006湖北黄石435000

【摘要】 目的探讨影响急性外伤性硬脑膜外血肿疗效的相关因素。方法对1994年5月至2004年5月收治的484例外伤性硬脑膜外血肿患者的临床资料进行回顾性分析。结果无脑疝症状者手术死亡率7.7%,有脑疝症状者死亡率21.3%。手术距脑疝发生时间<1h死亡率8.2%,1~2h死亡率40.0%,>2h死亡率72.2%。结论影响外伤性硬脑膜外血肿疗效的相关因素较多,除脑疝形成及手术距脑疝发生的时间外,创伤性低血压、合并脑损伤的程度、呼吸功能不全、大面积脑梗塞、血糖与血浆渗透压升高及肝功能异常等均对患者预后有重要影响。

【Abstract】 Objective To explore the factors related to curative efffcts on acute traumatic epidural hematomas. Method The clinical data of 484 patients with traumatic epidural hematomas treated in our hospital from May, 1994 to May, 2004 were analyzed retrospectively. Results Of 484 patients, 20 received conservative treatment and 464 surgery. The postoperative mortality was 7.7% in the patients with cerebral hernia and 21.8% in the patients without cerebral hernia. The mortality was 8.2% in the patients with cerebral hernia lasting less than 1 hour, 36.0% in the patients cerebral hernia lasting 1~2 hours and 78.6% in the patients with cerebral hernia lasting more than 2 hours. Conclusion The factors related to curative effect on traumatic epidural hematoma include cerebral hernia and its duration, hypotension, degree of cerebral injuries accompanying with the epidural hematoma, hypopnea, the extent of cerebral infarct, hyperglycemia, high plasmatic osmoltic pressure and abnormal hepatic functions.

【关键词】 硬脑膜外血肿颅脑损伤脑疝预后
【Key words】 Epidural hematomaBrain injuryCerebral herniaPrognosis
  • 【文献出处】 中国临床神经外科杂志 ,Chinese Journal of Clinical Neurosurgery , 编辑部邮箱 ,2006年06期
  • 【分类号】R651.15
  • 【被引频次】10
  • 【下载频次】59
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