CAJ | 학술논문

目的探讨颅骨钻孔引流术对于治疗儿童外伤导致亚急性硬膜下血肿的临床疗效.方法回顾分析60例因外伤导致亚急性硬膜下血肿,全组患儿均行颅骨钻孔引流术,其中有55例患儿术后行尿激酶生理盐水引流冲洗,术后随访2年以上,观察其疗效.结果术后随访2年以上,59例均临床治愈,术后血肿完全消失55例,残留少量薄层血肿(＜5 mm)4例于术后3个月后吸收,7例合并存在脑挫裂伤出现局部脑软化随访无明显神经功能障碍,5例患儿出现外伤后癫痫内科药物治疗后临床治愈,2例出现轻度脑积水,1例出现脑疝死亡.结论对于儿童外伤导致亚急性硬膜下血肿如对大脑产生压迫,深度超过1 cm,出现颅内压增高症状和体征时应进行外科治疗.颅骨钻孔引流术因手术创伤小,疗效好,大多数患儿预后较好.
목적 탐토로골찬공인류술대우치료인동외상도치아급성경막하혈종적림상료효.방법 회고분석60례인외상도치아급성경막하혈종,전조환인균행로골찬공인류술,기중유55례환인술후행뇨격매생리염수인류충세,술후수방2년이상,관찰기료효.결과 술후수방2년이상,59례균림상치유,술후혈종완전소실55례,잔류소량박층혈종(＜5 mm)4례우술후3개월후흡수,7례합병존재뇌좌렬상출현국부뇌연화수방무명현신경공능장애,5례환인출현외상후전간내과약물치료후림상치유,2례출현경도뇌적수,1례출현뇌산사망.결론 대우인동외상도치아급성경막하혈종여대대뇌산생압박,심도초과1 cm,출현로내압증고증상화체정시응진행외과치료.로골찬공인류술인수술창상소,료효호,대다수환인예후교호.
Objective To explore the clinical efficacies of drilling skull drainage for children with traumatic subacute subdural hematoma.Methods A total of 60 patients of subacute subdural hematoma underwent drilling skull drainage.And the follow-up period was 2 years or above.And 55 of them underwent urokinase saline irrigation.And their efficacies were observed.Results Among them,59 cases were clinically cured and hematoma disappeared postoperatively in 55 cases.A small residual hematoma (＜5 mm) persisted in 4 cases and became absorbed within the first 3 months.Seven cases had local brain softening,but there was no obvious nerve dysfunction.Post-traumatic epilepsy appeared in 5 cases and became cured clinically after medications.There were 2 cases of mild hydrocephalus and 1 case died.Conclusions Children with traumatic subacute subdural hematoma may cause brain oppression for deeper than 1cm.And the symptoms and signs of increased intracranial pressure should be managed surgically.Drilling skull drainage is mini-invasive and curative with a good prognosis.