老年人慢性硬脑膜下血肿的诊断与手术治疗

Surgical management and diagnosis of chronic subdural hematoma in elderly patients

目的探讨老年人慢性硬脑膜下血肿（CSDH）的诊断特点与手术方法。方法对37例经手术治疗的老年人慢性硬脑膜下血肿的临床资料进行回顾性分析，37例病人均采用颅骨钻孔冲洗并闭式引流术。结果术后2周内复查，15例残留少量血肿，2例复发而再次手术；8例颅内积气，2例手术后出现脑内出血，经治疗后留有中残；术后随访6～72个月，无手术病死。结论CT扫描或MRI检查可及时诊断老年人CSDH。颅骨钻孔冲洗并闭式引流术是治疗老年人CSDH安全有效的首选方法。

Objective To explore diagnosis features and surgical methods for chornic subdural hematoma （CSDH） in elderly patients. Methods 37 cases of surgically treated chornic subdural hematoma were analyzed retrospectively, All 37 patients were treated by bore holes craniotomy with closed drainage method. Results The fellow ups in two weeks after operation, 15cases had little hematoma,2cases were recurrence and had surgical treatment again ;8cases had pneumoencephalus ;2cases were intracerebral hemorrhage, after treatment become moderate disability ; Follow - up carry out from 6 - 72 months, there were no surgery related death. Conclusion Elderly patients with CSDH can be diagnosed immediately by CT scan or MRI test. Burr hole craniotomy with closed drainage should be the first choice method of safety and effectiveness for old patients with CSDH.