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目的探讨外伤性颅内迟发性血肿的临床特点、机制及治疗。方法回顾性分析近5年来收治的37例外伤性颅内迟发性血肿的临床资料。31例行颅骨切除清除血肿减压,6例在显微镜下行小骨窗切开清除血肿。结果本组37例再次行开颅血肿清除术。恢复良好15例,中残9例,重残5例,植物生存1例,死亡7例。结论脑挫伤、蛛网膜下腔出血、颅骨骨折、高龄为外伤性迟发性颅内血肿的高危因素,降低外伤性颅内迟发性血肿病死率和致残率的关键在于早期诊断和治疗,临床应采取相应的有效预防措施,并强调严密观察病情变化、及时复查CT,以便及时发现并再次手术清除继发性血肿。
Objective To investigate the clinical features, mechanism and treatment of traumatic intracranial delayed hematoma. Methods The clinical data of 37 cases of traumatic intracranial delayed hematoma admitted in recent 5 years were retrospectively analyzed. Thirty-one patients underwent skull resection to remove the hematoma decompression, and 6 patients underwent a small incision of the skull under a microscope to clear the hematoma. Results The group of 37 patients underwent craniotomy again. There were 15 cases recovered well, 9 cases were moderate disability, 5 cases were severe disability, 1 case was plant survival and 7 cases died. Conclusions Brain contusion, subarachnoid hemorrhage, skull fractures and elderly are the risk factors for traumatic delayed intracranial hematoma. The key to reduce the mortality and morbidity of traumatic delayed hematoma is early diagnosis and treatment, Clinical should take appropriate and effective preventive measures, and stressed the close observation of changes in condition, timely review of CT, in order to promptly find and re-operation to remove secondary hematoma.