CAJ | 학술논문

目的总结经皮穿刺结合开颅手术救治创伤性特急性颅内血肿的经验.方法采用经皮穿刺结合开颅减压手术对12例创伤性特急性颅内血肿的患者进行救治,其中硬膜下血肿7例,硬膜外血肿3例,硬膜外合并硬膜下血肿2例;术前双侧瞳孔散大6例,单侧瞳孔散大6例,呼吸改变8例.入院GCS 3分4例,4分6例,7分2例.结果穿刺后9例患者瞳孔有不同程度回缩,7例患者自主呼吸转平稳.手术后24 h内死亡2例,24 h后死亡4例,生存6例.随访6个月～2年.GOS评分良好4例,植物生存2例,死亡6例.结论经皮穿刺结合开颅手术是救治特急性颅内血肿的一种行之有效的方法.
목적 총결경피천자결합개로수술구치창상성특급성로내혈종적경험.방법 채용경피천자결합개로감압수술대12례창상성특급성로내혈종적환자진행구치,기중경막하혈종7례,경막외혈종3례,경막외합병경막하혈종2례;술전쌍측동공산대6례,단측동공산대6례,호흡개변8례.입원GCS 3분4례,4분6례,7분2례.결과 천자후9례환자동공유불동정도회축,7례환자자주호흡전평은.수술후24 h내사망2례,24 h후사망4례,생존6례.수방6개월～2년.GOS평분량호4례,식물생존2례,사망6례.결론 경피천자결합개로수술시구치특급성로내혈종적일충행지유효적방법.
Objective To discuss the experiences in successful treatment of hyperacute traumatic intracranial hematoma with percutaneous puncture and craniotomy.Methods Pereutaneous puncture and craniotomy was performed in 12 patients with hyperacute traumatic intracranial hematomas including seven with subdural hematoma,three with epidural hematoma and two with episubdural hematoma.Before operation,there found enlargement of bilateral pupil in six patients,enlargement of unilateral pupil in six and changed breathing rhythmicity in eight.Glasgow Coma Scale(GCS)was 3 points in four patients,4 points in six and 7 points in two.Results After pereutaneous puncture,enlarged pupil was retracted at different degrees in nine patients and spontaneous breathing conditions improved in seven.After crani otomy,two patients died within 24 hours,four died after 24 hours but six patients survived.The follow-up for 0.5-2 years showed four patients with sound Glasgow Outcome Score,two at vegetative state and six deaths.Conclusion Percutaneous puncture combined with craniotomy is an effective way for hyperacute intracranial hematoma.