慢性硬膜下血肿钻孔引流术后并发症及手术体会

Complications of Chronic Subdural Hematoma Drilling Drainage Surgery and Experience Analysis

目的:分析慢性硬膜下血肿钻孔引流的术后并发症,探讨术中及围手术期的注意事项,减少手术并发症。方法:回顾性分析62例经钻孔引流手术治疗的单侧慢性硬膜下血肿患者的临床资料,排除双侧慢性硬膜下血肿病例。结果:62例均明显好转或痊愈;其中17例(27.4%)术后早期出现少量颅内积气(<10ml),无张力性气颅;4例术后早期加行血肿腔内"尿激酶"灌注治疗后痊愈;1例术后1个月复发,改行开颅血肿包膜切除后痊愈;无导管误入脑实质病例,无术后脑脊液漏,无继发颅内感染及切口预后不良等。结论:钻孔引流手术是慢性硬膜下血肿安全、有效的治疗方法,注意手术细节及围手术期处理,可以减少并发症,提高疗效。

Objective：To explore the complication and its avoiding in chronic subdural hematoma drilling drainage surgery. Method：The clinical data of 62 unilateral cases by drilling drainage treatment were retrospective analysis, excluding the bilateral ones.Result：All cases were significantly improved or cured, with a small amount of pneumocephalus （ 〈10 ml ） in 17 cases （ 27.4%, none tension pneumocephalus ）, 4 cases of early postoperative hematoma which recovered after the ＂urokinase＂ reperfusion, and one recurrent case cured by hematoma capsule resection in one month after surgery.None catheter strayed into the brain parenehyma, no postoperative eerebrospinal fluid leakage, and no seoondary intraeranial infection and poor prognosis of incision.Conclusion：The drifting drainage surgery in chronic subdural hematoma is safe, effective, which complication and efficacy can be improved by taking attention to the surgical details and perioperative management.