单针、双针微创术治疗慢性硬膜下血肿的临床观察

Comparative study of treatment of chronic subdural hematoma with single needle or double needles mini-invasive surgery

目的比较单针与双针微创穿刺冲洗引流术治疗慢性硬膜下血肿(CSDH)的疗效。方法将60例CSDH患者随机分成单针组和双针组各30例,两组均采用微创穿刺冲洗引流术治疗,而单针组只用单针在血肿中部进行穿刺冲洗引流,双针组则在血肿的前部和中部各穿刺一针进行冲洗引流。术后24～72h复查头颅CT,对血肿清除量、平均冲洗次数、术后并发症发生率、术后平均住院日和住院费用进行比较。结果两组术后颅内血肿、颅内积气、蛛网膜损伤等并发症发生率比较无明显差异(P>0.05);但双针组与单针组比较,术后血肿清除更彻底,术后需冲洗平均次数明显少,而且平均住院日短,住院费用减少(P<0.05)。结论双针微创治疗CSDH效果更好,清除血肿更彻底,并缩短住院时间,减轻患者费用负担。

Objective To compare the curative effects on chronic subdural hematoma（CSDH） of single needle and double needles micropuncture irrigation and drainage. Methods 60 patients with CSDH were divided equally into single needle group and double needles, and were all treated with micropuncture irrigation and drainage. Patients were punctured, irrigated and drainaged in the middle of hematoma by single needle in single needle group, but in front and middle of hematoma in double needles group. Brain CT was performed 24 to 72 hours after the surgery. Clearance amount of hematoma, mean irrigation times ,complication rate after surgery, mean hospitalization days after surgery and hospitalization cost were compared between the two groups. Results There was no significant difference in complication rate of intracranial hematoma, intracranial aerocele and arachnoid injury after surgery between the two groups（ P 〉 0.05 ）. Hematoma clearance was more complete, mean irrigation times, hospitalization days and cost were less obviously in double needles group than in single needle group （ P 〈 0.05 or P 〈 0.01 ）. Conclusion Double needles mini-invssive surgery has better curative effect on CSDH, it could clear the hematoma much more completely, with shorter hospitalization days and less hospitalization cost for the patients.