急性硬膜下血肿合并脑挫裂伤22例手术治疗临床分析

目的探讨急性硬膜下血肿合并脑挫裂伤形成的机制、手术时机选择、手术治疗结果。方法手术治疗急性硬膜下血肿合并脑挫裂伤22例,无瞳孔散大常规开颅、保留骨瓣9例,单侧瞳孔散大去骨瓣减压8例,双侧瞳孔散大、行内外减压5例。结果 22例患者,恢复良好11例,中残6例,重残1例,植物状态1例,死亡3例。结论急性硬膜下血肿合并脑挫裂伤多为对冲伤,病情进展快,多需急诊手术治疗,采用不同的手术方式可改善患者预后。

The clinical analysis of 22 cases of operations treating acute subdural hematoma with brain contusion and laceration

Objective To evaluate the formative mechanism of the acute Subdural hematoma with Brain contusion and laceration,as well as the choosing for operation opportunity and the therapeutic result of the operation.Methods 22 cases of acute Subdural hematoma with brain contusion and laceration were treated by operation.The bone flaps in 9 cases were reserved due to no corediastasis.8 cases had their bone flaps removed due to unilateral corediastasis.Bilateral corediastasis happened to 5 cases and their bone flaps and brain tissues were removed.Results 11 cases are well recovered.There were 7 cases of moderate disability and 1 case of sever disability.1 case was in persistent vegetative state.3 cases died.Conclusion Most of Acute Subdural Hematoma are contrecoup injury and its conditions evolve quickly.Therefore it require emergent operation.Using multiple and different operation method can improve its prognosis.