颅骨钻孔与传统开颅术在处理硬膜外血肿的疗效比较

A comparision of curative effect between sphenotresia and traditional craniotomy in the treatment of epidural hematoma

目的比较颅骨钻孔/和联合尿激酶引流(SU)与传统开颅术式(CT)在处理硬膜外血肿(EDH)的疗效与安全性。方法 76例急性或亚急性EDH患者随机分为颅钻组及开颅组,每组各38例,分别给予颅骨钻孔或颅骨钻孔+尿激酶引流及开颅术治疗,比较二组术中出血量,手术时间,置管时间及住院时间。术后随访半年,比较术后并发症的例数构成。结果所有76例患者的手术均顺利完成,无出现死亡或致残;手术效果方面,颅钻组术中出血量明显少于开颅组(P=0.000),且手术耗时及住院时间亦明显短于开颅组(P=0.000,0.032)。并发症方面,两组在术后感染、头痛、再出血、癫痫及脑膜粘连的例数构成无统计学差异。结论颅骨钻孔与传统开颅术在处理硬膜外血肿的安全性相当,但前者的总体疗效优于后者。

Objective To compare the therapeutic effects and safety between sphenotresia and traditional open craniotomy（CT） in the treatment of patients with epidural hematoma （EDH）. Methods A total of 78 patients with EDH were divided into sphenotresia group and traditional craniotomy （both n=38）. The amount of intraoperative blood loss, the operation time, the indwelling drainage tube time and hospital stay were recorded and compared between two groups. All the patients were followed up for 6 months and the postoperative complicaions were compared between two groups. Results The operations were successfully completed in all patients and no cases of death and disablement..Blood loss in sphenotresia group was significantly less than that in the traditional craniotomy group（P=0.000）. The operation time and hospitalization time in sphenotresia group were also significantly shorter than that in the traditional craniotomy group （P=0.000 and 0.032）. However, postoperative infection,headache, rebleeding, epilepsy and meningeal adhesions had no difference between two groups. Conclusion Sphenotresia has the same security with traditional craniotomy in the treatment of epidural hematoma,but the overall effect of sphenotresia is better than that traditional open craniotomy.