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目的总结儿童创伤性颅后窝硬脑膜外血肿(PFEDH)的临床特点和诊治经验。方法回顾性分析30例经手术和(或)影像学检查确诊的儿童创伤性PFEDH的临床资料,其中车祸伤18例,坠落伤9例,跌伤3例;均有枕部着力伤。GCS评分:8～10分3例,11～12分9例,13～14分18例。根据血肿量和病人情况,采用非手术治疗或手术治疗。结果非手术治疗6例,伤后3个月复查CT血肿均完全吸收,神经系统检查未见明显异常;手术治疗24例,术后所有病儿病情平稳好转,头痛症状逐渐消失,术后CT显示血肿基本清除。本组无手术相关并发症。出院时病儿按GOS预后分级均恢复良好。结论枕部着力伴局部颅骨骨折的病儿发生PFEDH的风险大,如能早期诊断并及时处理,儿童创伤性PFEDH可获得良好疗效。
Objective To summarize the clinical features and diagnosis and treatment of traumatic posterior pit epidural hematoma (PFEDH) in children. Methods The clinical data of 30 children with traumatic PFEDH diagnosed by surgery and / or imaging examination were retrospectively analyzed. Among them, 18 were car accident injuries, 9 were falling injuries and 3 were dropped injuries. All had occipital injuries. GCS score: 8 to 10 in 3 cases, 11 to 12 in 9 cases, 13 to 14 in 18 cases. According to the amount of hematoma and the patient’s condition, non-surgical treatment or surgical treatment. Results Non-surgical treatment of 6 cases, 3 months after injury CT hematoma were completely rechecked, neurological examination showed no abnormalities; surgical treatment of 24 cases, all patients sick after a smooth improvement, headache symptoms disappear, postoperative CT showed Hematoma basically cleared. This group without surgery-related complications. Discharged children by GOS prognosis grading were recovered well. Conclusions The risk of PFEDH in children with occipital lobe and partial skull fracture is high. If early diagnosis and prompt treatment are available, the traumatic PFEDH in children can be treated well.