锥孔与钻孔引流手术治疗慢性硬脑膜下血肿的临床应用比较

A comparative study of taper-hole drainage and burr-hole drainage for chronic subdural hematoma

目的对慢性硬脑膜下血肿的锥孔引流和传统钻孔引流术疗效进行回顾性比较,以明确两种手术方法的优缺点,找出治疗慢性硬脑膜下血肿的最佳方法。方法锥孔组86例患者采用床边直接锥孔冲洗引流,钻孔组82例患者采用传统钻孔引流术。两组患者术后2～3 d复查头颅CT,对手术时间、术后并发症、症状改善、平均住院日、痊愈率及复发情况进行对比研究。结果两组患者均痊愈。两组患者住院期间主诉改善、术后继发血肿及复发情况等比较,差异无统计学意义(P>0.05)。锥孔组平均手术时间(35±5)min,少于钻孔组的(60±8)min;锥孔组平均住院日(6.5±0.5)d,少于钻孔组的(10.5±1.0)d;锥孔组颅内积气发生率明显少于钻孔组,两组对比差异均有统计学意义(P<0.05)。结论锥孔引流手术有创伤小、操作简便、手术时间及平均住院日短等优点。

Objective To retrospective compare effect of taper-hole drainage and burr-hole drainage on chronic subdural hematoma（CSH）,research the relative merits of two methods and find out the best way to treat CSH.Methods 86 patients in taper-hole group underwent bedside taper-hole irrigation drainage;82 patients in burr-hole group underwent burr-hole drainage.All of patients had CT review after 2～3d,and comparative study about operation time,postoperative complications,improving,average hospital stay,cure rate and palindromia was performed.Results Patients in two groups were all cured.The chief complaint improving during hospital stay,postoperative hematoma and palindromia were compared,the difference showed no statistical significance.Average operation time and average hospital stay of taper-hole group were（35±5）min and（6.5±5）d,less than burr-hole group（60±8）min and（10.5±1.0）d,respectively;the incidence rate of intracranial pneumatocele in taper-hole group was obviously less than burr-hole group,the difference between two groups had statistical significance（P〈0.05）.Conclusion Taper-hole drainage is characteristic of little trauma,easy to operate,less operation time and average hospital stay.