20例外伤性迟发性颅内血肿的临床分析

目的:探讨外伤性迟发性颅内血肿的临床表现、辅助检查、治疗方案和治疗效果。方法:对我院收治的20例外伤性迟发性颅内血肿患者的临床资料进行回顾性分析。结果:外伤性迟发性颅内血肿患者的临床表现,常表现出反复性。经过一段时间的平稳期,突然发病,病势发展迅速,之前稳定期一般不超过24 h。颅脑CT的检查结果显示,这类患者在发病前,常常无阳性表现,发病后CT阳性指征出现。治疗方案选择过程依据病情轻重,病情较轻患者常规处理,病情较重患者开颅处理血肿,合并脑疝患者行去骨瓣减压术,颅内减压。结论:外伤性迟发性颅内血肿的临床表现常出现反复,且预后不良,因此对颅脑外伤患者在24 h内应多次行颅脑CT检查,以排除DTIH的可能性。提早发现DTIH,是提高预后的有利因素之一。

The clinical analyze of 20 cases delayed traumatic intracranial hematomas

Objective To investigate the clinical manifestation,auxilliary examination,treatment protocols and efficacy of delayed traumatic intracranial hematomas(DTIH).Methods 20 cases of DTIH patients admitted in our hospital were analzyed retrospectively in this research.Results Recurrency was perfomed on DTIH patients in clinical.After a period of stable onset,the disease was suddenly happened,rapidly developed,and there was no more than 24 hours before the stabilization pertiod.The resluts of brain CT showed the positive findings were not befroe but after the disease.The chosen of the treatment protocols was based on the severity of the disease.For mild patients,conventional treatment was operated.However,for severe patients,craniotomy was carried out for treatement of the hematoma,and for combined cerebral hemia patients,bone flap removal treatment was operated to decrease the intracranial pressure.Conclusion Recurrent development and poor prognosis is showed for DTIH patients clinically.Therefore,multiple brain CT detection in 24 hours of brain injury can exclude the possibility of DTIH.It is one of the advantages of improving the prognosis to DTIH early.