儿童外伤性硬膜下血肿的临床救治及特征分析

目的探讨儿童外伤性硬膜下血肿的临床救治及特征,为临床有效治疗提供理论参考依据。方法对2011-02—2014-12我院诊治的58例外伤性硬膜下血肿患儿进行回顾性分析,根据患儿的具体病情采取不同的治疗方式,观察治疗效果并分析临床特点。结果行保守治疗患儿及钻孔引流术的患儿均痊愈,行开颅术20例患儿痊愈11例(55.00%),切口疝1例(5.00%),死亡2例(10.00%),感染1例(5.00%),伤残5例(25.00%)。儿童外伤性硬膜下血肿具有发病率相对偏低、颅内压升高缓、病情发展慢、易发贫血、休克、癫痫、意识障碍等特点,患儿出血部位主要为静脉出血、横窦表面及硬脑膜渗血。结论依据儿童外伤性硬膜下血肿临床特征及临床表现选择合理的治疗方法对于提高疗效具有一定的指导意义。

Clinical treatment and analysis of children with traumatic subdural hematoma

Objective To investigate the clinical treatment and characteristics of the children with traumatic subdural he‐matoma ,and to provide theoretical reference .Methods A retrospective analysis was made on 2011 February to 2014 December in our hospital receiving the treatment of 58 cases of traumatic epidural hematoma in children .According to the specific condi‐tion ,children were given different ways of treatment ,and then the treatment effect was observed and the clinical features were analyzed .Results Children with conservative treatment and borehole drainage were cured after discharge ,20 cases undergoing craniotomy ,healed in 11 cases (55 .00% ) ,1 case (5 .00% ) of incisional hernia ,death in 2 cases (10 .00% ) and infection in 1 case (5 .00% ) ,disability in 5 cases (25 .33% ) .Children with traumatic subdural hematoma with relatively low incidence rate , intracranial pressure increasing slowly ,slow development of the disease ,prone to anemia ,shock ,seizures ,disturbance of consciousness ,etc .The bleeding sites were mainly phleborrhagia ,transverse surface and dura mater .Conclusion According to clinical features and clinical manifestations of childhood traumatic subdural hematoma ,choosing reasonable treatment method has a certain guiding significance to improve the curative effect .