改进法闭式引流治疗慢性硬膜下血肿的疗效分析

Effectiveness of improved closed-drainage for treatment of chronic subdural hematoma

目的比较改进慢性硬膜下血肿闭式引流手术方法与常规闭式引流手术方法的效果。方法回顾性分析18例改进法闭式引流术后1 d和22例常规闭式引流术后3～4 d慢性硬膜下血肿患者的头颅CT扫描以及两组术后10 d头颅CT扫描,测量两组患者血肿腔内残留气体和液体量并进行统计学分析。结果改进法闭式引流组仅有微量气体和液体残留,而常规法闭式引流组则有较多气体和液体残留,两组血肿腔积气和液体残留量比较有显著统计学意义（P〈0.001）。结论改进法闭式引流手术是治疗慢性硬膜下血肿的更好的方法,符合生理,引流彻底,手术效果好。

Objective To compare the therapeutic efficacy of improved dosed - drainage （ICD） with that of conventional closed -drainage （CCD） in chronic subdural hematoma （CSDH） .Methods Eighteen patients with CSDH under going IC, D （ICD group）, and 22 patients with CSDH under going CCD （CCD group） were analyzed retrospectively. The volumes of air and fluid of residual haematoma cavity on the CT scans obtained on day 1 postoperation in ICD group and on days 3-4 postoperation in CCD group, and on day 10 postoperation in two groups were analyzed. Results ICD group had only trace residual gas and fluid. However CCD group had a large amount of subdural air and fluid. The residual air and fluid in ICD group were significantly less than those in CCD group. There was statistically significant difference in the volumes of residual air and fluid between the two groups（ P 〈 0.001）.Conclusions ICD is much better than CCD for chronic subdural hematoma;it conforms to physiology, drains comoletely, and achieres satisfactory operative effect.