新生儿及婴儿颅骨骨膜下血肿的转归及个体化治疗

目的 介绍新生儿及婴儿颅骨骨膜下血肿的转归规律及个体化治疗经验.方法 对148例新生儿及婴儿颅骨骨膜下血肿采用如下治疗方式:起初1个月内以观察随访为主,在此期间,如血肿自行消退,则不予干预处理;如1个月后血肿未明显缩小,而又没有出现钙化,则先给予止血药保守治疗.保守治疗1周后如血肿有缩小趋势,继续等待观察,待其自行消退.若血肿仍未缩小,则穿刺抽吸,防止血肿机化、钙化.结果 121例(82%)骨膜下血肿自行消失,27例(18%)血肿未消失,予止血药保守治疗,其中5例于1周后血肿逐渐消退,其余22例保守治疗无效,经穿刺抽吸后血肿消失.所有148例患儿均治愈.结论 大多数新生儿及婴儿骨膜下血肿可自行消退,故起初1个月应观察随访,待血肿自行消退,如1个月后血肿未明显缩小,则根据具体情况或给予药物止血或穿刺抽吸等干预措施.

Individual therapy for neonates and infants with subperiosteal hematoma

Objective To introduce the rule of turnover and therapy experience in neonates and infants with subperiosteal hematoma. Methods There were 148 neonates and infants with subperiosteal hematoma treated in our hospital between February 2000 and November 2007.The therapy methods were as following:Observation and follow-up for 1 month, if the hematoma resolved, no intervention was given;If it didn't resolve and calcification didn't occur after 1 month, the haemostat was administered;If the hematoma tended to reduce after the one-week conservative treatment,continued waiting and observation were recomended;If not,we treated the infants with needle aspiration to prevent organization and calcification of the hematoma. Results The subperiosteal hematoma was resolved spontaneously in 121 cases (82%) after 1-month observation.In 27 cases, it didn't resolve, so conservative therapy with the haemostat was given to these patients.The hematoma resolved one week later in 5 of them.The other 22 infants were healed after needle aspiration. All the 148 patients had good results.Conclusion Since most subperiosteal hematoma in neonates and infants could be resolved spontaneously,waiting and observation in the first month is appropriate. If it could not be resolved after 1 mouth, intervention such as haemostat or needle aspiration should be given.