摘要
硬膜外血肿的血肿位置主要位于颅脑内板和硬脑膜之间,多发生在幕上半球的凸面内,总体约占据颅脑损伤的30%,大多数小的血肿可自行吸收。依据2015年《中国颅脑创伤外科手术指南》,相当一部分需要外科手术急诊清除血肿。但对于伤后出血量较少,随着病程发展出血逐渐增多从而引起神经功能症状或障碍的血肿,是否可以提前予以干预及有效的治疗,以减少开骨瓣清除血肿的风险,减少住院时间,降低医疗费用,减少并发症是本次课题研究的重要内容。随着介入技术日新月异地发展,对颅内外较多的脑血管疾病诊断治疗已经获益,研究颇多,但对外伤性急性硬膜外血肿,由于脑膜中动脉损伤出血引起的血肿采用介入栓塞技术在国内尚未见相关的报道。鉴于欠发达地区颅脑损伤的发生率仍较高,本课题提出栓塞脑膜中动脉治疗急性硬膜外血肿的可行性及必要性进行探索,同时达到精准治疗目的。本研究拟通过筛选首次颅脑CT额顶部血肿<30 mL,颞部血肿<20 mL,最大层厚<15 mm,中线移位<5 mm的,GCS评分>8分,没有脑局灶损害症状和体征的病例,进行脑膜中动脉栓塞,分别从平均住院日、平均住院费用、疗效性、安全性等方面进行分析,为栓塞脑膜中动脉治疗额颞顶部的急性硬膜外血肿提供理论和临床依据。
The location of the hematoma in the epidural hematoma is mainly located between the brain internal plate and the dura mater,most of them occur in the convex surface of the supratentorial hemisphere,accounting for about 30%of craniocerebral injury,most small hematoma can be absorbed by itself.According to the 2015"Guidelines for Surgical Surgery of Brain Trauma in China",a considerable number of surgical emergency hematoma clearance is required.But for the less bleeding after injury,with the development of the course of bleeding gradually increased to cause neurological symptoms or disorders of hematoma,whether interventions and effective treatments can be given in advance to reduce the risk of open bone flap to remove hematoma,reduce hospitalization time,reduce medical expenses and reduce complications is an important part of this study.As the rapid development of interventional technology,the diagnosis and treatments of more intracranial and extracranial cerebrovascular diseases have benefited,but no report of interventional embolization of hematoma that caused by traumatic acute epidural hematoma hemorrhage.The incidence rate of craniocerebral injury in underdeveloped areas is still high,so the feasibility and necessity of embolization of middle meningeal artery in the treatment of acute epidural hematoma are exploring and the purpose of accurate treatment has achieved.This study intends to screen the first craniocerebral CT top frontal hematoma<30 mL,temporal hematoma<20 mL,maximum thickness<15 mm,center line shift<5 mm,GCS scale score>8 points,no brain focal damage symptoms and signs,meningeal middle artery embolization is performed to provide theoretical and clinical basis for the treatment of acute epidural hematoma at frontotemporal top by embolization of middle meningeal artery from the aspects of average length of hospital stays,average cost,efficacy and safety.
作者
唐权伟
吴学平
侯成林
王冬
谭皓
秦保平
Tang Quanwei;Wu Xueping;Hou Chenglin;Wang Dong;Tan Hao;Qin Baoping(The People's Hospital of Shizhu County,Chongqing 409100)
出处
《中国社区医师》
2020年第35期48-50,共3页
Chinese Community Doctors
关键词
栓塞脑膜中动脉
治疗
急性硬膜外血肿
可行性
Embolization of middle meningeal artery
Treatment
Acute epidural hematoma
Feasibility
