66例重度急性硬膜下出血的救治体会

目的探讨重度急性硬膜下出血的救治方法。方法回顾性地选择颅脑创伤后6小时内入院、首次头颅CT就显示硬膜下出血、GCS评分<9分的患者66例,分别予完全保守治疗8例,早期急诊手术22例,延期急诊手术治疗32例。余4例因病情过重未予治疗。结果早期急诊手术组死亡9例、重残5例、再手术8例,延期急诊手术组死亡3例、重残1例(P<0.05),保守治疗组完全恢复,仅3例有视力损害。结论延期急诊手术是重度急性硬膜下出血的主要治疗措施,恰当地运用保守治疗和选择合理的手术方式对提高患者生存率和生存质量有益。

The treatment experience of 66 cases severe acute subdural hemorrhage

Objective To discusses the therapeutic strategy of severe acute subdural hemorrhage. Methods Retrospectively choose 66 patients of traumatic brain injury, all patients were hospitalized within six hours after brain damage, first skull CTs showed traumatic acute subdural hemorrhage and GCS grades were less than 9 points. conservation therapy was choosed for 8 cases, early emergency operations for 22 cases, postponeded emergency operations for 32 cases and no operations for the rest 4 cases because of very severe states of illness. Results In the group of early emergency operations, nine patients died, 5 caseshad severe deficits, 8 operated again. In the group of postponeded emergency operations, 3 cases died 1 case had severe deficits (P<0.05). only 3 cases had vision demages in the group of medicative therapy. Conclusion Postponeded emergency operation is the major medical measure for severe traumatic acute subdural hemorrhage. It is beneficial for improving survival rate and quality to adopt correct medicative therapy and select reasonable operation methods.