外伤性硬膜下积液的治疗

【目的】探讨治疗外伤性硬膜下积液的合理方法。【方法】对42例获得随访的外伤性硬膜下积液患者(其中18例行钻孔引流术,24例行保守治疗)的临床资料进行分析。【结果】18例钻孔引流患者中有1例的硬膜下积液在住院期间治愈,其余患者硬膜下积液出院时未见减少,其中15例1~6个月随访积液好转或自愈,2例演变为慢性硬膜下血肿;另24例行保守治疗的患者,其中21例1~6个月随访积液好转或自愈,1例演变为慢性硬膜下血肿,2例积液扩大有颅高压表现者行开颅剥除包膜并打通外侧裂池,术后6个月后随访痊愈。【结论】多数外伤性硬膜下积液可经保守治疗好转或治愈,少数有颅高压症状需手术治疗,手术方式的选择以开颅剥除包膜并打通颅底脑池的脑脊液循环较为合适,钻孔引流的治疗效果较为有限。

Treatment of Traumatic Subdural Effusion

Objective]To discuss reasonable therapy to manage traumatic subdural effusion. Methods] There were 42 cases from Jan, 1997 to Dec, 2005, 18 of them underwent drill drainage, 24 cases underwent conservation therapy. Results]One of 18 cases with drill drainage got cured in hospital, others were uncured when leaving hospital. In 6 months, 15 cases self-cured;21 of 24 cases with conservation therapy were cured in 6 months, 2 cases underwent craniotomy and got cured after 6 months postoperatively. Conclusion]Most patients with subdural effusion can get self-cured, a few with high intracranial pressure need therapy. Operation should be craniotomy, not drill drainage.