重型颅脑损伤去骨瓣减压术后对侧血肿的病例对照研究

发布时间：2018-08-20 14:55

【摘要】：背景：对侧血肿是颅脑损伤行去骨瓣减压术后一种少见但严重的并发症。方法：回顾性收集于浙江大学医学院附属第一医院因重型颅脑损伤行去骨瓣减压术后出现对侧血肿的病例,通过病例对照研究的方法进一步分析病例组与对照组间的一般信息、术前GCS、术前CT特征及预后等差别。结果：共有16例患者发生对侧血肿这一并发症。多数为硬膜外血肿,14例在去骨瓣减压术后12小时内发现,包括3例在手术减压时发生。通过病例组与对照组的比较分析,发现对侧颅骨骨折是去骨瓣减压术后对侧血肿的主要危险因素。病例组与对照组之间的预后无显著差异。结论：去骨瓣减压术后对侧血肿的早期诊断及再次手术清除血肿是治疗的关键,对于术前CT提示存在对侧颅骨骨折的患者应在术后立即复查头颅CT以明确诊断。
[Abstract]:Background: contralateral hematoma is a rare but severe complication after craniocerebral injury. Methods: cases of contralateral hematoma after bone flap decompression in the first affiliated Hospital of Zhejiang University Medical College were retrospectively collected. The general information between the case group and the control group was further analyzed by case-control study. Preoperative GCSs, preoperative CT features and prognosis were different. Results: there were 16 patients with contralateral hematoma. Most of them were epidural hematoma, 14 cases were found within 12 hours after bone flap decompression, including 3 cases occurred during decompression. The contralateral skull fracture was found to be the main risk factor of contralateral hematoma after bone flap decompression. There was no significant difference in prognosis between the case group and the control group. Conclusion: the early diagnosis of contralateral hematoma after decompression of bone flap and the removal of hematoma by reoperation are the key points in the treatment. For the patients with contralateral skull fracture indicated by CT before operation, the head CT should be reviewed immediately after operation to make a definite diagnosis.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R651.15

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