小儿硬膜下血肿减压性颅骨切除术的回顾性分析
Retrospective analysis of decompressive craniectomy performed in pediatric patients with subdural hematoma.
作者信息
Taşkapılıoğlu M Özgür, Özmarasalı Ali İmran, Ocakoğlu Gökhan
机构信息
Department of Neurosurgery, Uludağ University Faculty of Medicine, Bursa-Turkey.
Department of Biostatistics, Uludağ University Faculty of Medicine, Bursa-Turkey.
出版信息
Ulus Travma Acil Cerrahi Derg. 2019 Jul;25(4):383-388. doi: 10.5505/tjtes.2018.02403.
BACKGROUND
The impact of decompressive craniectomy (DC) on the overall outcome of pediatric acute subdural hematoma patients has not been fully determined to date. In this paper, we aimed to investigate the role of decompressive craniectomy performed to treat traumatic subdural hematoma in patients from the pediatric age group.
METHODS
We described our experience with DC in pediatric acute subdural hematoma patients and analyzed the outcomes.
RESULTS
Eleven (7 unilateral and 4 bilateral) DCs were performed. The patients' ages ranged from 8 months to 15 years. The mean GCS score at admission was 7.8. All patients underwent DC with duraplasty within 2 hours of injury. All the patients were admitted to the intensive care unit for 10 days postoperatively. The mean hospital stay was 22 days and the mean follow-up period was 3.7 years.
CONCLUSION
Early DC for pediatric subdural hematoma patients, independent of their initial GCS, was recommended. Larger studies are needed to define the indications, surgical techniques, and timing of DC in the pediatric population.
背景
迄今为止，减压性颅骨切除术（DC）对小儿急性硬膜下血肿患者总体预后的影响尚未完全明确。在本文中，我们旨在探讨减压性颅骨切除术在治疗小儿创伤性硬膜下血肿患者中的作用。
方法
我们描述了在小儿急性硬膜下血肿患者中进行DC的经验并分析了预后情况。
结果
共实施了11例（7例单侧和4例双侧）DC手术。患者年龄从8个月至15岁不等。入院时平均格拉斯哥昏迷评分（GCS）为7.8分。所有患者均在受伤后2小时内接受了DC联合硬脑膜成形术。所有患者术后均入住重症监护病房10天。平均住院时间为22天，平均随访期为3.7年。
结论
建议对小儿硬膜下血肿患者尽早进行DC手术，而不考虑其初始GCS评分。需要开展更大规模的研究来明确小儿患者DC手术的适应证、手术技术及时机。
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