高危因素对外伤性迟发颅内血肿早期诊治意义.docVIP

高危因素对外伤性迟发颅内血肿早期诊治意义摘 要 目的：结合本组病例探讨分析导致外伤性迟发性颅内血肿发生的高危因素，以引起临床重视。方法：回顾分析2002～2007年68例外伤性迟发性颅内血肿病例资料，结合本组病例分析外伤性迟发性颅内血肿发生的主要相关因素。结果：脑挫裂伤或血肿对侧有脑挫裂伤；脑内血肿量大；颅骨骨折，尤其是跨脑膜中动脉或静脉窦的颅骨骨折是导致外伤性迟发性颅内血肿的高危因素，发生迟发性颅内血肿的危险性大。出凝血时间异常、癫痫发作、重症头皮损伤等对迟发性血肿的发生也起着一定的影响。结论：导致外伤性迟发性颅内血肿的相关因素较多，其中脑挫裂伤或血肿对侧有脑挫裂伤，脑内血肿量大，颅骨骨折，尤其是跨脑膜中动脉或静脉窦的颅骨骨折是其高危因素。重视、警惕导致外伤性迟发性颅内血肿发生的高危因素，在临床工作中可提高对外伤性迟发性颅内血肿的预见性，对其早期诊治起着较大的作用。? 关键词 外伤性迟发性颅内血肿 高危因素? Abstract Objective:We related to these cases of illness to discuss and analyze the high risk factors of the delayed traumatic intra cephalic hematoma (DTIH),to get a clinical respect.Methods:We have a retrospective analysis of 68 DTIH cases from 2002 to 2007,then relate to these cases to analyze the major correlate factors of DTIH.Resluts:It has a infection of delayed intracranical heamatoma such as contusion and laceration of brain or contusion and laceration of brain is on the offside of haematoma;a great deal of haematoma in the brain;fracture of skull,especially the fracture of sinus or medium artery of span meningeal,it is the high risk factors of DTIH,and it get high risk of delayde intracranical hematoma;abnormity of clotting time;falling sickness;a grave scalp injury etc.Conclusin:There are too many correlate factors that result in the DTIH,thereinto contusion and laceration of brain or contusion and laceration of brain is on the offside of haematoma;a great deal of haematoma in the brain;fracture of skull,especially the fracture of sinus or medium artery of span meningeal are the high risk factors. To have regard and keep our eye on the ball of the high risk factors of DTIH,we can advance the predictability of DTIH in the clinical work,it has biggish function to make a diagnosis and give treatment early.? Key words The delayed traumatic intra cephalic hematoma(DTIH);High risk factors 迟发性颅内血肿是一个影像学概念，是指颅脑损伤后首次CT扫描未发现血肿，经过一段时间后重复CT扫描、手术、尸解发现的血肿或在首次头颅CT检查证实有血肿，后其他部位又出现血肿[1]。随着CT的问世，外伤性迟发性血肿(delayed traumatic intracranial hematoma，DTIH)的诊断率明显提高，