創傷之延遲性硬腦膜外血腫

Delayed Traumatic Epidural Hematoma

楊之東(Jye-Dong Yang)

《中華民國急救加護醫學會雜誌》 9卷3期 (1998/09) Pp. 102-109

https://doi.org/10.30018/JECCM.199809.0002

摘要

「零死亡率及最少後遺症」是神經外科醫師對於急性外傷性硬腦膜外血腫病患治療的目標，達不到這個目標的主要原因是對於延遲性出血診斷及治療上的延誤。在兩年期間，本院（地區教學醫院）共有三十三位外傷性硬腦膜外血腫的患者接受手術治療。整體死亡率為百分之六，而百分之八十八的息者恢復良好。本篇報告針對其中十二位被定義為延遲性硬腦膜外血腫患者的經驗提出討論。我們的結論是嚴密的臨床觀察，臨床上有變化即追蹤腦部電腦斷層，及高度臨床上的懷疑是及早診斷出延遲性硬腦膜外血腫的方法。

關鍵字

最少後遺症 ； 延遲性出血 ； 硬腦膜外血腫

並列摘要

“Zero mortality and minimal morbidity” for epidural hematoma is the goal of neurosurgeon. The main reason for not attainning this goal is delayed diagnosis and treatment of delayed hemorrhage, which is not found initially. During a 2 year period, 33 patients with traumatic epidural hematoma(EDH) were admitted to the neurosurgical unit of this community teaching hospital, and managed with surgical evacuation by the same neurosurgeon. The overall mortality was 6%, and 88% of the patients made a good recovery. This report concerns our experience with 12 patients who was defined as delayed epidural hematoma(delayed EDH). Early diagnosis of delayed EDH can be facilitated by close clinical observation, liberal use of CT scanning, and high clinical suspicion.

並列關鍵字

minimal morbidity ； delayed hemorrhage ； epidural hematoma