侧裂池蛛网膜造瘘、置管外引流治疗外伤性硬膜下积液

Surgical management of traumatic subdural hygromas by sylvian arachnoid ostomy and subdural external drainage

目的探讨外伤性硬膜下积液显微手术治疗方法及其疗效。方法 22例经保守治疗无效的外伤性硬膜下积液患者,行翼点小骨窗入路、侧裂池蛛网膜造瘘+置管外引流治疗,对手术技术进行阐述并对临床资料及手术结果进行回顾性分析。结果无手术相关的并发症发生。术后1个月时,21例患者积液消失或明显好转;1例患者积液仍较多,后行硬膜下腔-腹腔分流后治愈。术后3个月时,所有患者积液消失或基本消失。结论经翼点小骨窗入路、侧裂池蛛网膜造瘘+置管外引流是治疗外伤性硬膜下积液安全、有效的方法。

Objective To evaluate the methods and effects of microsurgical treatment for traumatic subdural hygromas with microsurgery.Methods Failed in conservational treatments,22 cases of traumatic subdural hygromas were treated by sylvian arachnoid ostomy and subdural external drainage via pterional keyhole approach.The surgical details were described,and the clinical data were retrospectively reviewed as well as the surgical results.Results No complications occurred in our serial.One month after surgery,subdural hygromas disappeared totally or subtotally in 21 cases,whereas one patient was unchanged and it was necessary to perform a subdural to peritoneal shunt.Three months after surgery,subdural hygromas disappeared totally or subtotally in all patients.Conclusions Sylvian arachnoid ostomy and subdural external drainage via pterional keyhole approach is a safe and effective way for traumatic subdural hygromas.