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【摘要】目的探讨微创穿刺引流术治疗亚急性硬膜外血肿的疗效。 方法采用CT引导定位，血肿中心为靶点，Y-1型颅内血肿粉碎穿刺针经头皮穿刺冲洗粉碎引流联合尿激酶溶解血肿治疗亚急性硬膜外血肿46例。 结果所有患者均恢复良好，46例中有3例出现硬膜下积液，未做任何处理，2~3周后吸收。1例轻瘫患者出院后1个月完全恢复。结论微创穿刺引流术治疗亚急性硬膜外血肿安全性高、创伤小、术后恢复快，是一种行之有效的治疗方法。
【关键词】硬膜外血肿；钻孔引流； 尿激酶
Application of minimally invasive trepanation and drainage for traumatic subextradurai hematoma：A report of 46 cases Wang Hong-sheng. Department Of Neurosurgery. The People"s Hospital Of Yanzhou City. Shandong Province. Yanzhou 272100，China
【Abstract】ObjectiveTo explore curative effects of minimally invasive puncture and drainage in the treatment of traumatic subextradural hematoma． MethodsA total of 46 cases of traumatic subextradural hematoma was treated． Under the guidance of CT scanning，a puncture needle(type YL-1)was inserted into the lesion through the scalp．In addition，the urokinasewas administrated to dissolve the hematoma． ResultsAll cases got an excellent prognosis．Among 46 cases，3 cases，who suffered subdural hydrops，improved automatically after 2-3 weeks；1 case with mild paralysis completely recovered after 1 month． ConclusionMinimally invasive trepanation and drainage is a kind of effective, safer and less-trauma method for the treatment of traumatic subextradural hematoma．
【Key words】 Subextradural hematoma； Puncture and drainage； Urokinase
我院自1998年12月至2005年12月，对亚急性硬膜外血肿采用钻孔引流和注入尿激酶等微创治疗46例，效果满意，现报告如下。
1资料与方法
1．1一般资料本组男36例，女l0例；年龄19～59岁，平均35.2岁；伤后至手术时间3～8 d。致伤原因：车祸伤38例，坠落伤3例，打击伤5例。
1．2临床表现伤后昏迷16例，无昏迷34例。住院观察期间有头痛、头晕50例，呕吐l6例，外耳道出血2例，癫痫发作2例，2例有血肿对侧肢体轻度活动障碍，Babinski征(-)，术前GCS评分达l3～l5分。
1．3CT征象及血肿量本组46例均至少行2次CT扫描，血肿量按V=1/2长×宽×层面厚度计算，最少20 ml，最多50 ml，平均40 ml。血肿部位：额部25例，颞顶部15例，枕部6例。脑室受压者22例，中线偏移但
