影响急性外份性硬脑膜外血肿疗效的相关因素分析（附484例报告）

目的探讨影响急性外伤性硬脑膜外血肿疗效的相关因素。方法对1994年5月至2004年5月收治的484例外伤性硬脑膜外血肿患者的临床资料进行回顾性分析。结果无脑疝症状者手术死亡率7.7%,有脑疝症状者死亡率21.3%。手术距脑疝发生时间<1h死亡率8.2%,1～2h死亡率40.0%,>2h死亡率72.2%。结论影响外伤性硬脑膜外血肿疗效的相关因素较多,除脑疝形成及手术距脑疝发生的时间外,创伤性低血压、合并脑损伤的程度、呼吸功能不全、大面积脑梗塞、血糖与血浆渗透压升高及肝功能异常等均对患者预后有重要影响。

Analyse is of the Factors Related to Curative Effects on Acute Traumatic Epidural Hematomas

Objective To explore the factors related to curative efffcts on acute traumatic epidural hematomas. Method The clinical data of 484 patients with traumatic epidural hematomas treated in our hospital from May, 1994 to May, 2004 were analyzed retrospectively. Results Of 484 patients, 20 received conservative treatment and 464 surgery. The postoperative mortality was 7.7% in the patients with cerebral hernia and 21.8% in the patients without cerebral hernia. The mortality was 8.2% in the patients with cerebral hernia lasting less than 1 hour, 36.0% in the patients cerebral hernia lasting 1~2 hours and 78.6% in the patients with cerebral hernia lasting more than 2 hours. Conclusion The factors related to curative effect on traumatic epidural hematoma include cerebral hernia and its duration, hypotension, degree of cerebral injuries accompanying with the epidural hematoma, hypopnea, the extent of cerebral infarct, hyperglycemia, high plasmatic osmoltic pressure and abnormal hepatic functions.