微创清除术在外伤性颅内血肿合并严重多发伤救治中的应用

目的探讨微创颅内血肿清除术在外伤性颅内血肿合并严重多发伤中的应用。方法选择外伤性硬膜外和硬膜下血肿合并严重多发伤患者47例,23例行微创颅内血肿清除术,24例行开颅血肿清除术,对比两种血肿清除术在严重多发伤救治中的差异。结果两组患者总体治愈率、并发症发生率、死亡率相近,差异无统计学意义。但微创组从患者入院到开始手术的时间及颅内血肿清除的时间明显短于开颅组;术中,术后的用血量,术后血管活性药使用时间以及ICU住院时间,微创组均显著少于开颅组。结论微创颅内血肿清除术有助于外伤性颅内血肿合并严重多发伤的整体救治,值得更深入地研究、总结。

Evacuation of intracranial hematomas by micro-invasire surgery in patients with multiple trauma including cranio cerebral injury

Objective To explore the micro-invasire surgery used for removal of intracranial hematomas in patients with craniocerebral injury and severe multiple trauma.Methods All of 47 patients with severe multiple trauma ,some of them also with extradural hematoma(EDH) or subdural hematoma(SDH),were studied.Twenty-three cases received micro-inrasive survey to evacuate of intrancranial hematomas(micro-invasire group),24 cases received craniotomy to evacuate the hematomas(craniotomy group ) ,their curative effect were investigated.Results The curative rate,complication rate,and death rate in this two groups had no significant difference.But the micro-invasive group has the advantage of operation time and shortening ICU stay.conclusions The micro-invasives surgey to evacuate intracranial of hematomas is an effective method on craniocerebral injury with severe multiple trauma,and is worthy of advanced studies.