双侧慢性硬膜下血肿的微创治疗

Minimal invasive surgery of bilateral chronic subdural hematoma

目的探讨双侧慢性硬膜下血肿的诊治方法及效果。方法回顾性分析2001-04～2006-05收治的28例双侧慢性硬膜下血肿的临床资料,首诊即行颅脑CT检查22例(79%),MRI检查16例(57%)。首诊误诊3例,漏诊1例。28例术前诊断均正确。治疗方法均采取局麻下行双侧钻单孔冲洗引流术。结果27例术后均痊愈,1例出现硬膜下积液,全组无死亡病例。结论双侧慢性硬膜下血肿确诊的首选方法是颅脑CT,必要时辅以MRI检查;双侧钻单孔微创术为首选治疗方法,效果良好。

Objective To explore the diagnosis methods and minimal invasive surgical outeom of bilateral chronic subdural hematoma. Methods 28 patients with bilateral chronic subdural hematomas（BCSDH） were retrospectively reviewed from April of 2001 to May of 2006. As to first hospitalization, 22 patients underwent cranial CT, 16 patients underwent cranial MRI. All patients got correct diagnosis before operation. However,3 patients couldn＇t got correct diagnosis and on side in one patient was not diagnosed. We launched bilateral single twist-drill eraniostomy with irrigation and drainage in every patient. Reslults 27 patients had good outcome without recurrence after operation, but one patient had subdural hydroma, and no patient was dead. Conclusion Cranial CT should be taken before you make correct diagnosis. In addition, cranial MRI is taken when necessary ; minimal invasive surgery of bilateral single twist--drill eraniostomy with irrigation and drainage is a chief method to BCSDH, and has good outeom.