慢性硬膜下血肿手术治疗的并发症及防治

The prevention and treatment of complication following surgical operation of chronic subdural hematoma

目的 探讨慢性硬膜下血肿术后并发症的发生原因及防治。方法 通过总结96例慢性硬膜下血肿手术及术后并发症回顾性研究,整理临床资料,结合文献复习从中得出一定经验及方法。结果 全部患者均接受手术治疗,其中69例出现术后并发症,发生率为71.9％,经相应治疗均获治愈。27例在术中术后采取必要的方法避免了并发症的发生。结论 慢性硬膜下血肿手术治疗的并发症常见为:颅内积气、血肿复发、脑脊液漏、癫痫和继发性颅内血肿。预防术后并发症应强调术中早封闭骨孔,控制放液速度,反复充分冲洗硬膜下腔,以及仔细操作,避免损伤蛛网膜和脑组织等。只要注意术中术后的细节处理,可以避兔术后并发症的出现。

Objective To investigate the cause and the way of prevention and cure for the postoperative complication following surgical treatment of Chronic Subdural Hematoma (CSDH) . Methods Through summarizing the clinical data of the operation and the postoperative complication in 96 patients with CSDH, some clinical experiences and methods of prevention were obtained to cure for the postoperative complication. Results All patients underwent operation among 96 cases , there were 69 cases (71.9%) with postoperative complication which was cured correspondingly and healed at last . Necessary measure was taken to avoid the postoperative complication occurring during and after the operation in 27 cases. Conclusion The common complication following the operation of CSDH consist of intracranial aerocele , recurrent hematoma , cerebrospinal fluid leakage , epilepsy and secondary intracranial hemato-ma .To prevent from postoperative complication, it was emphasized to adopt closing skull hole earlier , controlling drainage speed , flushing subdural space repeatedly and operate carefully to avoid injuring arachnoid and brain during operation , etc . The paper indicated that the postoperative complication following the operation of CDSH can be avoided , if only specific management is taken during and after operation.