硬膜悬吊与硬膜外引流对145例开颅手术硬膜外血肿的影响

Effect of epidural drainage and dural tenting suture on epidural hematoma in 145 cases of craniotomy

目的:评估硬膜悬吊与硬膜外引流在开颅手术中预防硬膜外血肿的意义。方法:对2009年1至7月在中南大学湘雅医院神经外科就诊的145例颅内病变患者,行开颅手术进行治疗。采用硬膜悬吊与硬膜外引流两种技术预防硬膜外血肿。结果:术后计算机X射线断层扫描(CT)复查所有病例均未发现有需外科处理之硬膜外血肿。结论:无论是硬膜悬吊还是硬膜外引流对于预防开颅手术硬膜外血肿都有积极作用,但手术区彻底有效的止血才是预防的关键。硬膜悬吊不放置硬膜外引流可以减轻患者的心理压力,有利于尽早开展术后康复,避免了拔管损伤,同时降低了术后颅内感染的风险。

Objective To evaluate the efficacy of dural tenting suture and epidural drainage in craniotomy.Methods In 145 cases of intracranial lesions,dural tenting suture and epidural drainage were performed to prevent epidural hematoma.Results Postoperative computed tomography（CT）showed no epidural hematoma required surgery in both groups.Conclusion Both dural tenting suture and epidural drainage are effective in preventing epidural hematoma.Hemostasis is the key step.Dural tenting suture without epidural drainage relieves psychological stress.It decreases the risk of intracranial infection and avoids some unusual complications.