婴儿外伤性非产伤性硬膜外血肿的手术治疗.DOCVIP

PAGE PAGE 1 婴幼儿创伤性硬膜外血肿的临床特点 梁 平，翟 瑄，周渝冬，李映良，李禄生，于增鹏，夏佐中（重庆医科大学附属儿童医院神经外科，重庆 400014） 摘 要：目的 探讨婴幼儿硬膜外血肿的临床特点。方法 回顾性分析73例婴幼儿创伤性硬脑膜外血肿的临床表现及特点，应用婴幼儿神经创伤评分（TINS）方法评估婴幼儿伤情。结果 常见临床表现为头皮血肿、呕吐、意识障碍、抽搐；致伤原因绝大多数为坠落伤；手术治疗28例，非手术治疗45例。69例治愈、3例有肢体功能障碍、1例放弃治疗。结论 婴幼儿创伤性硬膜外血肿的发病机制、临床表现、诊断、治疗均有不同于年长儿及成人硬膜外血肿的特点；婴幼儿创伤性硬膜外血肿经积极治疗预后良好。 关键词：婴幼儿；创伤性硬膜外血肿；婴幼儿神经创伤评分（TINS） 中图法分类号： 文献标识码：A Clinical fFeatures of Ttraumatic eEpidural Hhematomas in iInfants LIANG Ping , ZHAI Xuan , ZHOU Yu-dong , LI Ying-liang , LI Lu-sheng , YU Zeng-peng , XIA Zuo-zhong（ (Department of Neurosurgery，, Children’s Hospital，, Chongqing Medical University. ，Chongqing, 400014, ，China）) Abstract：Objective To investigate the clinical features of traumatic epidural hematomas (EDH) in infants. Methods The clinical features of 73 infants with traumatic EDH were retrospectively analyzed. The trauma infant neurologic scorTINingS scoring system (TINS) was used to evaluate the degree of injury. Results The most common clinical presentations were scalp hematoma, vomiting, disturbance of consciousness and convulsion. Most of the injuries cameresulted from falling., Among the 73 cases, 28 cases were treated by operation and 45 cases have non-operation treatment. In all patients, 69 cases were recoveredcured, extremity motor dysfunction was in 3 cases and abandoning treatment in 1 case. Conclusions The pathogenesis, clinical presentation, diagnosis and treatment of traumatic EDH in infants are different withfrom older children and adults. Positive Aggressive treatments can come out good prognosis in infants with traumatic EDH. Key words：iInfants; Eepidural hematoma (EDH); Ttrauma Infant infant Neurologic neurologic Score score (TINS) 婴幼儿创伤性硬膜外血肿较年长儿及成人少见，但仍是婴幼儿创伤性颅内血肿的主要类型，临床表现不典型，诊断和伤情评估比较困难[1]。本院2002年6月至2008年6月6年期间收治73例婴幼儿创伤性硬膜外血肿，回顾其资料及有关文献，分析婴幼儿创伤性硬膜外血肿的临床表现、诊断和治疗特点。 1 资料与方法 1.1 一般资料 选择本科2002年6月至2008年6月收治的年龄0～36个月，因外伤致硬膜外血肿（头颅CT扫描确诊）的婴幼儿，其中男性40例，女性33例，年龄22 h至36个月，平均15.9个月；受伤至入院时间＜1 d 36例，1~2 d