Traumatic epidural hematoma in children: 41 cases report
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摘要:
目的 探讨儿童外伤性硬脑膜外血肿影响术后预后的因素。 方法 分析我院神经外科自2013~2016年收治的41例硬脑膜外血肿手术患儿（均<14周岁）的临床特点、影像学表现及治疗方法，对采取不同手术时机对患儿的预后及其影响因素进行分析。 结果 41例手术患儿全部采取开颅手术，术后恢复较好34例，轻微残疾3例，死亡患者4例。两组患儿预后不良比例的差异有统计学意义（χ2=50.111，P<0.05），6~24 h组患儿预后不良的比例高于<6 h组（43%vs 12%, P<0.05）。 结论 儿童外伤后手术时机的选择、颅内损伤的严重程度、硬膜外血肿的部位及手术操作等因素对患儿的预后具有较大影响。 Abstract:Objective To investigate the prognostic factors of traumatic epidural hematoma in children. Methods The clinical features, imaging findings and therapeutic method of 41 cases with epidural hematoma in children who were admitted to our hospital from 2013 to 2016 were analyzed. The prognosis in different time of surgery and the factors affecting the prognosis of the operation were evaluated. Results Forty-one cases were treated by craniotomy, 34 cases with postoperative recovery, 3 cases with mild disability and 4 cases dead. The differences of poor prognosis ratio in children between the 2 groups were significant. The poor prognosis ratio in 6-24 h group was significant higher than that of <6 h group. Conclusion Timing of surgery, severity of intracranial injury, epidural hematoma location and the operation have a great impact on the prognosis of the children. -
Key words:
- child /
- epidural hematoma /
- poor prognosis /
- epidural hematoma
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图 2 患儿术后2.5 h复查头颅CT
右侧颞顶枕叶大面积脑梗塞; 入院后急诊行开颅血肿清除、去骨瓣减压术, 术后2.5 h患者突发呼吸急促, 后双侧瞳孔不等大, 最终结果为死亡出院.A: 层面一; B: 层面二.
表 1 两组患儿预后不良比例的比较
入院时间（h） GOS（分） n 比例（%） <6 5 30 88 4 2 6 3 0 0 2 0 0 1 2 6 6~24 5 4 57 4 1 14* 3 0 0 2 0 0 1 2 29* *P<0.05vs <6 h组. 
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