软通道技术在早期急性硬膜下血肿合并脑疝中的应用价值探讨

Explore Therapeutic Value of Soft-tube Technology in Acute Subdural Hematoma with Hernia

目的:探讨软通道技术在严重颅脑创伤中急性硬膜下血肿合并脑疝形成患者术前的应用价值。方法:将2010年1月～2012年1月因重型颅脑损伤后急性硬膜下血肿合并脑疝行去骨瓣减压术的76例患者随机分为两组,软通道组38例即在去骨瓣减压术前快速应用软通道技术引流血肿,对照组38例快速滴入甘露醇250ml后直接行去骨瓣减压术手术。血肿清除去骨瓣减压术方式及术后治疗方法相同。同时将相关数据进行回顾性分析研究。结果:软通道引流能降低ICP,减少常规钻颅引流的并发症。通过比较两组术前散大瞳孔变化及术后GCS评分,软通道组更具有优势,差异具有统计学意义(P<0.05)。结论:软通道引流技术在急性硬膜下血肿合并脑疝术前能有效降低颅内压,为后期开颅手术赢得时间,并改善预后,值得临床推广。

Objective：To investigate the application of the soft-tube technology in acute subdural hematoma with hernia cases suffered from severe traumatic brain injury.Methods：76 cases of decompressive craniectomy in acute subdural hematoma with herniation followed severe head injury,from January 2010 to January 2012,were randomly divided into two groups.Soft-tube group of 38 cases：rapid soft-tube drainage of hematoma before decompressive craniectomy.Control group of 38 patients：decompressive craniectomy after rapid infusion of mannitol 250ml.Removing of hematoma,decompressive craniectomy and postoperative treatment were in the same way.The data were retrospectively analyzed.Results：Both of ICP and the complications of conventional drilling drainage could be reduced in soft-tube drainage technology.By comparing the two groups of preoperative dilated pupil and postoperative GCS score,more advantages were in the group of soft-tube drainage,the difference was statistically significant（P0.05）.Conclusion：Intracranial pressure could be reduced in the acute subdural hematoma with hernia by soft-tube drainage technology.More time of craniotomy were gained,the prognosis were improved.The methods was worthy of promotion.