外伤迟发性颅内血肿42例诊治体会

目的：探讨外伤性迟发性颅内血肿的发病机理、临床特点、诊断和治疗。方法：回顾性分析1995年3月～2004年3月收治的42例外伤性迟发性颅内血肿。结果：42例外伤性迟发性颅内血肿中，行开颅血肿清除术20例，锥颅血肿内置管 增强尿激酶引流术12例，非手术治疗10例。40例治愈，2例死亡，死亡率4．78％。结论：进行性意识障碍加重、头痛、呕吐和生命体征不稳定是外伤性迟发性颅内血肿的基本临床特征，高度警惕本病的发生，及时再次CT扫描有利于早期诊断；掌握好手术和非手术治疗的指征，是治愈本病的关键。

Delayed traumatic intracerebral hematioma

Objective:To explor clinical characteristics,diagnosis and treatment of delayed traumatic intracranial hematoma(DTIH).Methods:Forty-two patients with DTIH treated in our hospital frommarch 1995 tomarch 2004 were retrospectively analyzed.Results:Hematoma debridement was performed in 20 cases.A combinant method ie,catheteter placed at the hematomas plus drainage with injection of urokinase,was done in 12 cases.The other 10 cases did not receive operation.Of all,40 patients were cured but two died with a death rate of 4.78%.Conclusion:The unstable physical signs like continual decrease of consciousness,headache,vomiting are the essential clinical characteristics.Repeated CT scanning is valuble for an early diagnosis.The key to cure of DTICH lies in mastering the indication of surgical operation or on-operation.