慢性硬膜下血肿96例诊治体会

Diagnosis and treatment of chronic subdural hematomas(a report of 96 cases )

目的探讨慢性硬膜下血肿的诊断、治疗及提高疗效的注意事项。方法选择我科96例慢性硬膜下血肿患者,全部病例均经头颅CT扫描证实诊断、判断出血量;采用单侧或双侧钻孔、冲洗、引流的治疗方法。结果术后血肿腔引流量最少50ml,最多450ml;头颅CT复查,90例(93.8%)仅见少量残存血肿(<10ml);创腔积气2例;4例症状加重,CT示血肿量较大,行开颅手术清除血肿;双侧血肿病例单侧钻孔的3例对侧血肿增多,行对侧钻孔引流。结论钻孔引流术是治疗慢性硬膜下血肿的首选最佳治疗方法,它创伤小、疗效显著、恢复快,对老年患者大大降低了手术风险;正确的操作是提高疗效的保证。

Objective To investigate the diagnosis, treatment of chronic subdural hematomas and it＇s attention to improving curative effect. Methods 96 patients with chronic subdural hematomas were selected and whose diagnosis and hemorrhage volume were approved by CT scans. All cases were treated by single side or two sides boring, douching, and drainage. Results The drainage volume of hematomas was from 50 ml to 450 ml showed in CT imagings. 90 cases had a few residual hematomas （ 〈 10ml）. 2 eases had intracranial gas. 4 patients had aggravated symptoms and increased hematomas, and had to be operated by craniotomy. 3 patients of two sides of hematoinas with single side boring were showed increased hematomas in CT scans, and bored in the other side. Conclusion Trepanation and drainage is the preferred and best way to treat chronic subdural hematomas, which has little trauma, marked effects and quick recovery, especially debases the risk of operation in aged patients. Correct operation is the guarantee of good effects.