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外伤性硬膜下积液是神经外科临床中的常见疾病。为更好地探讨疾病的诊断治疗,保障患者的生命健康,笔者结合其他学者的相关研究进行综述,首先是分析外伤性硬膜下积液的病因与发病机制,其中主要包括单向活瓣学说、血脑屏障破坏学说、高渗透压学说、颅内压平衡失调学说、脑脊液吸收障碍学说等;之后就结合患者临床诊断进行分析,由于疾病表现得不典型,临床诊断依赖于影像学检查;最后就治疗方案展开探讨。临床治疗的方法多样,主要分为保守治疗和手术治疗,现在多以保守治疗为主。保守治疗措施包括避免增高颅内压的因素,防治癫痫,维持内环境稳定,合理使用脱水剂,改善脑血液循环等;手术治疗包括经皮前囟穿刺术、钻孔引流术、腰大池穿刺置管持续引流术、硬膜下腔-腹腔分流术、蛛网膜造瘘及颞肌填塞术、开颅包膜切除术、脑室镜术等。
Traumatic subdural effusion is a common clinical neurosurgical disease. In order to better explore the diagnosis and treatment of diseases and protect the life and health of the patients, the author summarizes the relevant research of other scholars. The first is to analyze the etiology and pathogenesis of traumatic subdural effusion, including the theory of one-way valve , Theory of destruction of the blood-brain barrier, theory of hyperosmotic pressure, theory of imbalance of intracranial pressure, theory of cerebrospinal fluid imbalance, etc .; then combined with the clinical diagnosis of patients, because the disease is not typical, clinical diagnosis depends on the imaging examination; finally Discuss the treatment plan. Various methods of clinical treatment, mainly divided into conservative treatment and surgical treatment, and now mostly conservative treatment. Conservative treatment include avoiding elevated intracranial pressure factors, prevention and treatment of epilepsy, maintaining stable internal environment, rational use of dehydrating agents, improve cerebral blood circulation, etc .; surgical treatment including percutaneous transluphus, drainage drilling, lumbar puncture Continuous drainage tube, subdural - peritoneal shunt, arachnoid fistula and temporal muscle packing, craniotomy, endoscopic surgery.