DXM治疗亚急性硬膜下血肿的临床研究

目的 探讨亚急性硬膜下血肿（sASDH）的药物治疗方法。方法 按知情同意原则，根据患者或家属的愿意选择钻孔引流手术或行地塞米松（DXM）治疗。DXM的使用方法：前3天每日10mg，以后每日5mg。停药时间分为两组，A组硬膜下血凝块完全溶解后停药；B组临床症状消失后3天停药。分析两组患者的病史资料和神经影像学资料。结果 A、B两组，使用DXM后临床症状均当天消失。A组5例停药后症状未再复发；B组4例，停药时仍有硬膜下血凝块存在，头痛症状均复发，2例改为手术治疗，另2例继续使用DXM （同A组）治愈。结论 DXM是治疗sASDH的有效药物，用药的终点应该在硬膜下血凝块完全溶解以后。

Study on Dexamethsone Treatment for Subacute Subdural Hematoma

Objective To explore drug treatments for subacute subdural hematoma (sASDH). Methods Trephination surgery or dexamethasone (DXM) treatment was chosen according to the wish of the patients or their family with informed consent. The usage of DXM was 10mg daily in the first three day, and 5mg once a day in the subsequent days. According to the time of drug discontinuance, patients was divided into two groups, group A:the time of drug discontinuance was at the day when subdural clot hematoma was dissolved; group B:the time was at the 3th day after symptoms disappeared. The clinical and neuroimaging data were analyzed. Results The clinical symptoms disappeared on the day when DXM was used in both groups. 5 cases in group A were managed with DXM till subdural clot hematoma vanished without recurrence. 4 cases in group B all recurred. And there was still subdural clot hematomas when DXM was stopped. 2 cases turned to surgery and the other two continued using DXM as group A did, and them healed in the end. Conclusion DXM is effective for sASDH. The terminal point of DXM treatment should be after that the subdural clot hematoma is dissolved completely.