晚发性维生素K缺乏性颅内出血外科治疗316例

目的探讨晚发性维生素K缺乏性颅内出血的外科治疗方法及疗效。方法回顾性分析天津市儿童医院神经外科自2000年1月至2013年12月收治并确诊的316例晚发性维生素K缺乏性颅内出血患儿的临床资料,分析手术治疗时机的选择,对比非手术治疗评价其临床治疗结果。结果316例患儿中符合外科手术指征的共167例,其中接受手术治疗的101例,平均住院时间(16±1.9)d,治愈75例,好转26例,治愈率74.3%;有手术指证但拒绝手术治疗的66例,平均住院时间为(28±1.8)d,放弃治疗10例,治愈5例,好转51例,治愈率8.93%。结论积极的手术治疗,能够明显提高晚发性维生素K缺乏性颅内出血患儿的抢救成功率,早期手术治疗较非手术治疗的患儿住院时间更少,治愈率更高。

Surgical treatment for late vitamin K deficiency intracranial hemorrhage:a report of 316 cases

Objective To explore the surgical treatment of late vitamin K deficiency intracranial hemor-rhage. Methods Retrospective analysis was performed for 31 6 children with late intracranial hemorrhage due to primary vitamin K deficiency from January 2000 to December 201 3. Their clinical data and operative timing were compared with those of non-operative measures to evaluate the clinical efficacies. Results Among them, 1 67 cases had operative indications and 1 01 children were operated. The average hospitalization duration was 1 6 ±1.9 days. The outcomes were curing (n=75 )and improvement (n=26 ). And the curative rate was 74.3%. And 66 cases with operative indications declined operation. The average hospitalization duration was 28 ±1.8 days. The outcomes were dropout (n=10),curing (n=5)and improvement (n=51 ). And the curative rate was 8.93%. Conclusions Aggressive operative interventions can significantly improve the suc-cessful rescue rate of late intracranial hemorrhage due to primary vitamin K deficiency in children. As compared with non-operative measures,early operation reduces hospitalization duration and has a higher curative rate.