论文下载：特急性颅内血肿手术时机的选择-脑膨出-脑肿胀-天幕裂孔切开

特急性颅内血肿手术时机的选择

http://www.100md.com 2011年1月15日盛军席等国李伯炜

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     【摘要】目的总结特急性颅内血肿的发展规律、临床特点及诊治经验，选择正确的手术时机。方法回顾性分析笔者所在科近6年121例特急性颅内血肿患者的临床资料。通过对其临床表现、影像学特征的分析研究，找出特急性颅内血肿的发展规律，发现最佳手术时机。结果根据GOS评分判断预后，非手术治疗43例，恢复良好21例(488%)，中残7例(163%),重残3例(70%)，植物生存4例(93%),死亡8例(186%)。手术治疗78例：恢复良好38例(487%)，中残10例(128%),重残9例(115%)，植物生存9例(115%),死亡12例(154%)。结论对入院有误吸、低血压、缺氧情况存在及颅内多发血肿早期尽量保守治疗，改善供氧，动态CT观察，选择好手术时机可避免或减少脑膨出发生。对迟发血肿导致脑膨出，根据头颅CT和临床表现分析脑膨出原因，采取正确方案。【关键词】特急性颅内血肿脑膨出脑肿胀天幕裂孔切开

    Analysis of treatment of peracute intracranial hematomaSHENG Jun,XI Deng-guo，LI Bo-wei. Wuxi New District Pheonix Hospital,Wuxi 214028,China【Abstract】ObjectiveTo summarize developmental tendency, clinical characteristics and therapeutical experience of peracute intracranial hematoma and to choose correctly operative or non-operative method.MethodsTo retrospecively analyze the clinical data of 121 cases for peracute intracranial hematoma for about 6 years. Summarizing on clinical characteristics and iconographic manifestation, we found developmental tendency, optimal therapeutic time and method.ResultsAccording to GOS score, in non-operative 43 cases, 21 cases(488%) were survived in good condition, 7 cases(163%) had moderate disability, 3 cases(70%) had severe deficit, 4 cases(93%) were vegetative and 8 cases(186%) were dead. In operative 78 cases, 38 cases(487%) in good condition, 10 cases(128%) had moderate disability, 9 cases(115%) had severe deficit, 9 cases(115%) were vegetative and 12 cases(154%) were dead ......

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