中颅窝底硬膜外血肿的分型和诊治分析(附21例报告)

目的对21例中颅窝底硬膜外血肿进行分型,分析其临床及CT特点、手术时机和手术要点。方法对21例患者的临床资料进行回顾性分析。结果重型和中型组手术治疗,轻型组先保守治疗,4例中转手术。6月后按GOS评估,重型组恢复良好3例,中残2例,重残2例,死亡1例;中型组中残1例,良好4例;轻型组死亡1例,良好7例。结论中颅窝底硬膜外血肿有特殊的临床特点和CT表现;重型即刻手术,中、轻型手术指征要放宽,选择合理的手术方案,抓住手术要点,有利于改善预后。

Classification and treatment of epidural hematoma in middle fossa base of 21 cases

Objective To classify the epidural hematoma in the middle fossa base of 21 cases and analyze clinical and CT features,discuss operative indications and highlights of each classification. Method The clinical data of 21 cases with epidural hematoma in the middle fossa base were analyzed retrospectively. Results The severe and the middle group were treated by surgery.8 cases of low-grade group were treated nonoperatively,but 4 of them had to adopt operation subsequently.Assessed the prognosis after six months according to GOS,In severe group 1 died,2 became severe disability,2 were of moderate disability and 3 had good recovery.In middle group,moderate disability occurred in 1 case,good recovery in 4 cases.In low-grade group,1 died and 7 had good recovery. Conclusions Epidural hematoma in middle fossa base have exclusive clinical characteristics and CT features.The severe cases should be operated on emergently;the others should be operated on more actively than usual.Reasonable surgical planning would improve the outcome.