中国冶金工业医学杂志

微创穿刺治疗小儿硬膜外血肿

作者：史占华1 赵鸿玲2 颉卫东1

单位：1包头市中心医院神经外科内蒙古包头 014010 2内蒙古包头市北方医院功能科

关键词：穿刺小儿硬膜外血肿

分类号：R 72

出版年,卷(期):页码：2016,33(1):6-7

摘要：

摘要：目的探讨小儿硬膜外血肿微创穿刺手术的优点。方法根据CT片定位，以血肿厚度最大层面为穿刺点，取YL\|I型一次性粉碎穿刺针自穿刺点垂直于头皮钻入，放出部分血肿，然后用稀释有尿激酶的生理盐水缓慢冲洗，术后CT评估去除血肿已起到减压作用后，用生理盐水3 ml+2万单位尿激酶注入血肿腔内夹闭引流管2 h后开放，每日重复1～2次，2～3 d后再次复查头CT了解血肿情况后决定是否拔除穿刺针。结果术后立即CT复查均无血肿增大表现，其中有2例患儿手术后CT复查血肿已清除彻底，术后2～3 d后再次复查头CT其余病例显示血肿基本消失，出院时根据GOS评分，均达到恢复良好标准。结论微创穿刺手术是小儿硬膜外血肿的理想治疗手段，能降低患儿的手术风险，减少患儿并发症，缩短住院时间。

关键词：穿刺；小儿；硬膜外血肿

Abstract:ObjectiveTo investigate the advantages of minimally invasive puncture operation of pediatric epidural hematomaMethodsAccording to CT imaging,the maximum level of hematoma was chosen as puncture point,with one\|time crushing puncture needle of type YL\|I,penetrating at puncture point perpendicular to the scalp,release part of the hematoma,then wash the cavity of hematoma with 09% sodium chloride injection with diluted urokinase gently,evaluating the effect of removing partial hematoma and decreased pressure by CT after operation,inject 3ml 09% sodium chloride injection and 20000u urokinase into hematoma cavity and clip the drainage tube 2 hours,after open it,repeat 1 ~ 2 times each day,brain CT scan were underwent after 2 ~ 3 days to observe hematoma and decide whether to pull out puncture needleResultsCT scan were underwent immediately after operation,all patients revealed no hematoma increasing,including 2 cases of hematoma being removed thoroughly;all patients were well as recovery according to GOS scores when they leaved from hospitalConclusionThe minimally invasive puncture operation is an ideal treatment for pediatric epidural hematoma,can reduce the risk of operation and the incidence of complications,shorten hospitalized timeKey Words:Puncture;Pediatric;Epidural hematoma

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参考文献：

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\[4\]王银生，张中原，张久蛟，等急性外伤性硬膜外血肿的微创穿刺治疗\[J\]中国微创外科杂志，2013,2（3）：175\|177 

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