慢性硬膜下血肿钻孔引流术后并发症及防治

Complications of chronic subdural hematoma drained through drilled holes and prophylaxis and treatment

目的探讨慢性硬膜下血肿钻孔引流术后并发症发生的原因及相应治疗措施。方法对收治的慢性硬膜下血肿(CSDH)行钻孔引流术的135例进行回顾性分析,并对发生并发症的32例进行分析和讨论。结果32例并发症:颅内血肿4例,颅内积气24例,脑脊液漏3例,血肿复发8例,癫痫发作3例,颅内感染1例,心衰1例,其中6例合并多种并发症;治愈128例,未愈6例,死亡1例,死于术后继发心衰。结论对慢性硬膜下血肿行钻孔引流术患者,做好术前病情分析,认真阅读影像学资料,制定切实可行的手术方案是降低并发症的重要手段。

Objective To investigate complication causes of patients with chronic subdural hematoma drained through drilled holes and corresponding treatment. Methods 135 cases with chronic subdural hematoma treated by drainage through drilled holes were retrospectively investigated, and 32 cases with complications were analyzed and discussed. Results 32 cases were complicated with different complications： 4 cases with intracranial hematoma, 24 with intracranial pneumatosis, 3 with leakage cerebrospinal fluid, 8 with haematoma relapse, 3 with epileptic attack, 1 case with intracranial infection and 1 case with heart failure. 6 cases had multiple complications. 128 cases among all cases cured of. Hematomas in 6 cases had not absorbed. 1 case died of secondary heart failure after operation. Conclusion Condition analysis, careful observation of imaging materials and formulation of practical and feasible surgery plan are very important means to reduce complications in patients with chronic subdural hematoma drained through drilled holes.