探讨不同手术方式对于慢性硬膜下血肿术后复发的影响

Approach to influence of recurrence of various surgical treatments of Chronic Subdural Hematoma

目的探讨不同手术方式对于CSDH患者术后血肿复发的影响。方法回顾性分析142例CSDH患者的临床及神经影像学特征、手术方式及术后复发的关系。结果142例患者均采用手术治疗,术后13例复发中,2例术前服用阿司匹林类药物。术前CT表现为高密度或混杂密度20例,表现为等密度46例,表现为低密度76例;双侧血肿14例;锥钻引流术38例,钻孔引流术90例。结论锥钻引流术与钻孔引流术都是治疗慢性硬膜下血肿的有效方法,两者术后复发率无明显差异(0.50>P>0.25);开颅血肿清除术后复发率最低。

[ Objective] To investigate the influence of hematoma recurrence of various surgical treatments of Chronic Subdural Hematoma. [Methods] The clinical features, radiological findings, operative techniques and recurrence of 142 patients with CSDH were analysized retrospectively. [Results] All the patients （142） were initially treated by surgery, 13 out of 142 patients recurred, of 13 patients, 2 cases had a usage of aspirin in these 13 recurred patients; with the brain computerized tomography （CT） preoperatively, 20 were in high-density or mixed-density type, 46 were in isodense type, 76 were in low-density type and 14 had bilateral-CSDH; 38 were treated by twist-driU drainage and 90 were treated by burr-hole drainage. [Conclusion] Twist-drill drainage and burr-hole drainage are both effective treatment of CSDH and there is no statistical significance difference in the recurrence of CSDH between them （0.50〉P 〉0.25）; Craniotomy has the lowest recurrence.