幕上下联合入路治疗骑跨横窦幕上下平均型枕部硬膜外血肿分析

目的 探讨幕上下联合入路治疗骑跨横窦幕上下平均型枕部硬膜外血肿的方法及适应证。方法 回顾分析淮北市人民医院幕上下联合入路手术治疗骑跨横窦幕上下平均型枕部硬膜外血肿患者的临床资料,17例患者伤后3 h内均行头颅CT及颅骨三维重建,急诊清除血肿,保留骨桥并悬吊硬膜。随访3个月,GOS评价术后恢复情况。结果 17例患者术后生命体征基本平稳,随访3个月,GOS评分均为5分,患者术后恢复良好。结论 骑跨横窦幕上下平均型枕部硬膜外血肿病情进展迅速,病死率高。早期确诊,准确把握手术指征,及时手术,术中保留骨桥、妥善处理横窦是成功抢救骑跨横窦幕上下平均型枕部硬膜外血肿患者的关键。

The combined supra-and infra-tentorial approach to average supra-and infra-tentorial occipital epidural hematoma straddling transverse sinus

Objective o explore the combined supra-and infra-tentorial approach to average supra-and infra-tentorial occipital epidural hematoma(OEH) straddling transverse sinus.Methods The clinical data of 17 patients of our department from January 2012 to April 2015 were analyzed retrospectively. They all received cranial CT, 3D reconstruction of skull bone, emergency evacuation of hematoma, retention of bone bridge and suspense of dura mater in three hours after injury. The patients were then followed up for three months to evaluate the recovery by GOS.Results All the 17 patients recovered well.Conclusion This case often progresses rapidly with high mortality. Therefore, early diagnosis, accurate identification of operation indication, and timely surgery with retention of bone bridge and proper treatment of transverse sinus are the keys to rescue such patients successfully.