中国实用神经疾病杂志2024，Vol.27Issue(9)：1141-1145,5.DOI:10.12083/SYSJ.231198
骑跨横窦硬膜外血肿的临床特征 手术方式及预后分析
Analysis of clinical features,operative treatment and prognosis of epidural hematoma of transverse sinus
摘要
Abstract
Objective To analyze the clinical characteristics,surgical treatment and the prognosis of patients with epidural hematoma of transtransverse sinus.Methods The clinical data of 80 patients with epidural hematoma of straddle transverse sinus admitted to the People's Hospital of Wuzhou from December 2018 to December 2022 were retrospectively analyzed.The clinical characteristics,surgical treatment and prognosis of the patients were analyzed,and the risk factors affecting the poor prognosis of the patients with epidural hematoma of the transversal sinus were analyzed by Logistic regression.Results There were 65 cases of headache,frequent nausea and vomiting,10 cases of primary coma,2 cases of high blood pressure and slow pulse.CT showed 68 cases of occipital fracture.The first CT examination revealed hematoma in 70 cases and delayed hematoma in 10 cases.The sources of bleeding were:35 cases of fracture line,18 cases of transverse sinus,6 cases of sinuses,6 cases of retropapillary vascular bleeding.There were 15 cases of frontal temporal contusion,15 cases of annulus disappearance and 19 cases of midline displacement.After operation,54 patients had a good prognosis(67.5%)and could live independently.The level of GCS score in the poor prognosis group was lower than that in the good prognosis group(P<0.05),and the proportion of hematoma volume,NIHSS at admission,injury to operation time>24 hours was higher than that in the good prognosis group(P<0.05).Logistic regression analysis showed that GCS score at admission,hematoma volume,NIHSS score at admission,and time>24 hours from injury to operation were all independent risk factors for poor prognosis in patients with transtransverse sinus epidural hematoma(P<0.05).Conclusion There are no typical clinical features in the early stage of epidural hematoma of transtransverse sinus,and the incidence of delayed hematoma is high,which is easy to miss diagnosis.Therefore,CT examination should be performed on patients as soon as possible,and the changes of clinical symptoms should be closely monitored,so as to adopt appropriate surgical methods according to the specific conditions of patients in time,which is conducive to improving the prognosis of patients.In addition,GCS score at admission,hematoma volume,NIHSS score at admission,and time>24 hours from injury to operation were all independent risk factors for poor prognosis in patients with transversal sinus epidural hematoma.关键词
骑跨横窦硬膜外血肿/临床特征/手术方式/预后/危险因素Key words
Straddling transversal sinus epidural hematoma/Clinical features/Surgery mode/Prognosis/Risk factors分类
临床医学引用本文复制引用
江南凯,黄常坚,李荣卓,张焕威,欧嘉华..骑跨横窦硬膜外血肿的临床特征 手术方式及预后分析[J].中国实用神经疾病杂志,2024,27(9):1141-1145,5.基金项目
广西壮族自治区卫生厅自筹经费科研课题(编号:Z2012704) （编号:Z2012704）
