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目的探讨CT平扫显示有“漩涡征”的急性硬膜外血肿伤后致手术时间与手术疗效的相关性。方法分析2005年2月至2015年12月接受手术治疗并获得随访的36例CT平扫显示有“漩涡征”的急性硬膜外血肿的患者的临床资料,根据伤后至接受手术的时间分为早期手术组(伤后3 h内手术,共17例)和晚期手术组(伤后3~6 h内的手术,共19例),比较两组ADL评分,分析伤后至手术时间与ADL评分的相关性。结果本研究36例患者术后均获得了6个月的随访。早期手术组术后6个月ADL评分显著优于晚期手术组,差异有统计学意义(P<0.01)。早期手术组术后6个月恢复优良率显著高于晚期手术组,差异有统计学意义(P<0.01)。手术时间与ADL评分间呈正相关(r=1.54,P<0.05)。结论 CT平扫显示有“漩涡征”的急性硬膜外血肿的患者伤后至手术时间与手术疗效呈负相关,早期手术疗效优于晚期手术疗效,伤后至手术时间越短,手术疗效越好,患者术后病死率及致残率越低。
Objective To investigate the correlation between the operative time and the curative effect of acute epidural hematoma after CT scan showed “swirling sign”. Methods The clinical data of 36 patients with acute epidural hematomas with CT scan showed “swirling sign” after surgery and follow-up from February 2005 to December 2015 were analyzed retrospectively. Time was divided into the early surgery group (surgery within 3 h after injury, a total of 17 cases) and the late surgery group (surgery within 3 to 6 h after injury, a total of 19 cases), ADL scores were compared between the two groups analysis of injury to surgery time Correlation with ADL score. Results All 36 patients in this study were followed up for 6 months. The ADL score of the early operation group was significantly better than that of the late operation group at 6 months after operation, the difference was statistically significant (P <0.01). The excellent and good rate of recovery in the early operation group was significantly higher than that of the late operation group at 6 months after operation, the difference was statistically significant (P <0.01). There was a positive correlation between operation time and ADL score (r = 1.54, P <0.05). Conclusions CT scan showed that the patients with acute epidural hematoma of “whirlpool sign” had a negative correlation between the time from injury and operation, the effect of early operation was better than that of late operation, the shorter the time from injury to operation, The better the curative effect, the lower the postoperative morbidity and mortality.