摘要
目的探讨钻孔引流改进术对慢性硬膜下血肿(chronic subdural hematoma,CSDH)远离术区颅内出血的影响。方法回顾性分析2007年5月至2018年3月行CSDH钻孔引流术患者700例,将350例常规术式的患者设为常规组,另350例患者在常规手术的基础上通过术中缓慢释放血肿液及术后设置引流装置的高度来控制引流速度这两方面来改进钻孔引流术,设为手术改进组。比较两组患者术后远离术区颅内出血发生率,死亡率及3个月随访的残疾率。结果 CSDH术后远离术区颅内出血常规组(14例,4.00%)高于手术改进组(2例,0.57%),差异有统计学意义(P<0.05);常规组死亡率(2例,0.57%)高于手术改进组(无死亡),差异无统计学意义(P=0.479);术后3个月常规组残疾率高于(7例,2.00%)手术改进组(1例,0.29%),差异无统计学意义(P=0.075)。结论通过术中缓慢释放血肿液及术后设置引流装置的高度来控制引流速度这两方面来改进钻孔引流术,能有效降低CSDH术后远离术区颅内出血的发生。
Objective To explore the effect of a improved drilling and drainage of chronic subdural hematoma on remote intracranial hemorrhage.Methods Seven hundred patients undergoing(CSDH)drilling and drainage from May,2007 to March,2018,were analyzed retrospectively.Patients were divided into the regular and surgical improvement groups.Regular group included 350 patients receiving conventional surgery and surgical improvement groups consisted of 350 patients receiving conventional surgery based on the slow release of hematoma fluid during operation and the height of the drainage device to control the drainage velocity to improve the drilling and drainage.The incidence of remote intracranial hemorrhage from the surgical site,mortality,and disability rate at 3 months follow-up were compared between the two groups.Results The remote intracranial hemorrhage after CSDH surgery was significantly higher in the regular group(14 cases,4.00%)than in the surgical improvement group(2 cases,0.57%).The mortality was slightly higher the regular group(2 cases,0.57%)than in the surgical improvement group(no death)(P=0.479).The rate of disability was slightly higher in the regular group 3 months after surgery(7 cases,2.00%)than in the surgical improvement group(1 case,0.29%)(P=0.075).Conclusion The drilling and drainage can be improved by slowly releasing the hematoma fluid during operation and setting the height of the drainage device to control the drainage velocity.The improved drilling and drainage can effectively reduce the incidence of remote intracranial hemorrhage after CSDH.
作者
旷仁钊
李舜
唐文国
唐晓平
KUANG Renzhao;LI Shun;TANG Wenguo;TANG Xiaoping(Department of Neurosurgery,The Affiliated Hospital,North Sichuan Medical College,NanChong 637000,China.)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2019年第1期7-10,共4页
Chinese Journal of Nervous and Mental Diseases
关键词
慢性硬膜下血肿
手术
颅内出血
Chronic subdural hematoma
Operation
Intracranial hemorrhage
