摘要
目的观察颅骨钻孔引流联合尿激酶溶栓治疗小儿创伤性硬膜外血肿(tEDH)的效果。方法选取2016年8月—2018年1月河北省儿童医院神经外科收治的tEDH患儿60例,采用随机数字表法分为对照组和观察组,每组30例。对照组患儿行开颅血肿清除术治疗,观察组患儿行颅骨钻孔引流联合尿激酶溶栓治疗。比较两组患儿手术时间、术后住院时间、住院费用和格拉斯哥预后量表(GOS)分级,记录两组患儿随访2～3个月血肿复发情况。结果观察组患儿手术时间、术后住院时间短于对照组,住院费用少于对照组,GOS分级优于对照组(P<0.05)。两组患儿随访期间均未出现血肿复发。结论颅骨钻孔引流联合尿激酶溶栓治疗可有效缩短格拉斯哥昏迷量表(GCS)评分≥8分且血肿量为20～50 ml的tEDH患儿手术时间、术后住院时间,减少住院费用,改善患儿预后。
Objective To observe the effect of sphenotresia and drainage combined with urokinase thrombolytic therapy in treating children with traumatic epidural hematoma.Methods From August 2016 to January 2018,a total of 60 children with traumatic epidural hematoma were selected in the Department of Neurosurgery,Hebei Children's Hospital,and they were divided into control group and observation group according to random number table,each of 30 cases.Children in control group received craniotomy for hematoma evacuation therapy,while children in observation group received phenotresia and drainage combined with urokinase thrombolytic therapy.Duration of operation,postoperative hospital stays,hospitalization costs and GOS grading were compared between the two group,and recurrence of hematoma was recorded during the 2-to 3-month follow up.Results Duration of operation and postoperative hospital stays in observation group were statistically significantly shorter than those in control gruop,hospitalization costs in observation group was statistically significantly less than that in control group,and GOS grading in observation group was statistically significantly better than that in control group(P<0.05).No one in the two groups occurred recurrence of hematoma during the follow-up.Conclusion In traumatic epidural hematoma children with GCS score equal or over 8 and hematoma volume between 20 to 50 ml,sphenotresia and drainage combined with urokinase thrombolytic therapy can effectively shorten the duration of operation and postoperative hospital stays,reduce the hospitalization costs and improve the prognosis.
作者
方江顺
王贤书
杨志国
程征海
曹红宾
李鑫
高飞飞
刘叶
FANG Jiang-shun;WANG Xian-shu;YANG Zhi-guo;CHENG Zheng-hai;CAO Hong-bin;LI Xin;GAO Fei-fei;LIU Ye(Department of Neurosurgery,Hebei Children's Hospital,Shijiazhuang 050031,China)
出处
《实用心脑肺血管病杂志》
2018年第12期87-90,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
血肿
硬膜外
颅内
儿童
颅骨钻孔引流术
尿激酶
治疗结果
Hematoma,epidural,cranial
Child
Sphenotresia and drainage
Urokinase
Treatment outcome
