小儿外伤性硬膜下积液的诊治

目的 探讨小儿外伤性硬膜下积液的诊断和外科治疗.方法 回顾性分析62例小儿外伤性硬膜下积液,均由CT或MRI确诊,根据积液量和病程采取保守或手术治疗,观察疗效.结果 14例经保守治疗后痊愈.48例行手术治疗,其中12例行前囟侧角穿刺持续引流,14例行颅骨钻孔硬膜下腔置管外引流,12例行开颅清除积液、切除脏层囊壁,10例行蛛网膜造瘘及颞肌填塞术.术后痊愈36例,好转8例,无效4例,无死亡.结论 小儿外伤性硬膜下积液患儿可根据不同的积液量和病程采用相应的治疗措施.如原发脑损伤不重,治疗及时合理,预后良好.

Diagnosis and treatment for traumatic subdural effusion in children

Objective To evaluate the diagnosis and surgical treatment for traumatic subdural effusion in children. Methods The clinical data of 62 children with traumatic subdural effusion were analyzed retrospectively. All the patients were diagnosed by CT or MRI, and were cured by operation or non-operation treatment. Results Fourteen cases recovered by non-operation treatment. Forty-eight received surgical treatment, and repeated tapping was performed in 12 cases. Fourteen cases underwent trepanation and drainage. Twelve cases underwent drainage by craniotomy. Ten cases underwent arachnoid fistulation and temporal muscle graft. Thirty-six cases of them were cured, 8 cases were improved and 4 cases failed to respond. Conclusion The choice of treatment depends on the different clinical symptoms and capacity of effusion in children.