外伤性硬膜下积液产生机制及治疗（附36 例临床分析）

张占英1 ，张方成2

（1.江苏盱眙县人民医院神经外科，江苏 淮安，211700；2.华中科技大学同济医学院附属协和医院神经外科， 湖北 武汉，430022）

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摘要：

目的 探讨外伤性硬膜下积液（TSE）的产生机制及治疗。方法 回顾性分析36 例外伤性硬膜下积液病例资料，所有患者住院期间均给予营养神经药物，停用一切脱水降颅压药物。采用手术钻孔引流3 例，腰大池引流2例，保守治疗31例。结果 本研究中出现硬膜积液患者40岁以上约占86%，50岁以上约占60%，60岁及以上约占42%；手术钻孔3例，1 例术后4周转变为慢性硬膜下血肿，2例治愈；2例腰椎穿刺引流治愈；保守治疗31例，1例4周后演变为慢性硬膜下血肿，30例治愈。结论 硬膜下积液患者年龄越大发病率越高，首选保守观察治疗，脑组织受压时可采取手术治疗，早期预防性处理可以降低 硬膜下积液发生情况。

关键词：硬膜下积液；保守治疗；手术治疗

中图分类号：R651.1 文献标志码：A文章编号：2096-1413(2017)32-0014-02

Mechanism and treatment of traumatic subdural effusion with 36 cases of clinical analysis
ZHANG Zhan-ying 1, ZHANG Fang-cheng 2
(1. Department of Neurosurgery, Xuyi County People``s Hospital, Huai``an 211700; 2. Department of Neurosurgery,Tongji Medical College of Huazhong University of Science and Technology Affiliated Wuhan Union Hospital, Wuhan 430022, China)

ABSTRACT: Objective To explore the mechanism and treatment of traumatic subdural effusion (TSE). Methods The clinical data of 36 cases of TSE were analyzed retrospectively. All patients during hospitalization were given nutrition nerve medicine and stopped using the medicine for dehydration and reducing intracranial pressure. Three cases used drilling operation, 2 cases used lumbar pool drainage and 31 cases were given conservative treatment. Results In this study, patients above 40, 50 and 60 years old accounted for about 86%, 60% and 42% respectively. Among 3 cases who were given drilling operation, 1 cases became chronic subdural hematoma at postoperative 4 weeks, and 2 cases were cured. Two cases with lumbar puncture drainage were cured. Among the 31 cases who were given conservative treatment, 1 case became chronic subdural hematoma after 4 weeks, and 30 cases were cured. Conclusion The higher age gets, the higher incidence of subdural effusion becomes. The first choice to treat subdural effusion is conservative treatment, and surgery can be used for the treatment of brain tissue compression. The early preventive treatment can reduce the incidence of subdural effusion.
KEYWORDS: subdural effusion; conservative treatment; surgical treatment

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