儿童创伤性后颅窝硬膜外血肿手术治疗17例

摘要

Objective To investigate the surgical indications and suigical procedures of traumatic posterior fossa epidural hematomas of 17 cases in children.Methods Clinical data of 17 children who admitted into our hospital from 2010 to 2015 with posterior fossa epidural hematomas were retrospectively reviewed.We summarized he surgical indications and operation selection of posterior fossa epidural hematomas in children.Results The suigical procedures of all patients in our group included the following:8 patients were treated with traditonal craniectomy,9 patients were treated with drilling skull plus urokinase.All patients recovered well after operation.Complications:hydrocephalus in 2 cases,epilepsy in 1 case.The outcome evaluated using the Glasgow outcome score(GOS) was good in 15 patients,mild disability in 1,severe disability in 1.Conclusion The clinical status of posterior fossa epidural hematoma can progress rapidly in children.It is crucial for early diagnosis and timely surgical intervention when it is indicated.In addition,the surgical procedures should be selected properly,the overall prognosis is excellent.%目的 探讨儿童外伤性后颅窝硬膜外血肿手术指征及手术术式.方法 回顾性分析笔者医院2010 ～ 2015年收治的17例儿童外伤性后颅窝硬膜外血肿的临床资料,总结后颅窝硬膜外血肿的手术指征和手术方式选择.结果 本组17例患儿的手术术式包括传统开颅血肿清除术8例,颅骨钻孔结合尿激酶引流术9例,术后均治愈.术后并发症:脑积液2例,癫痫1例.按格拉斯哥预后评分(GOS):恢复良好15例,轻残1例,重残1例.结论 儿童外伤性后颅窝硬膜外血肿病情进展迅速,早期诊断,对有手术指征的患儿积极手术干预至关重要,同时合理选择手术术式,总体预后良好.