慢性硬膜下血肿术后并发症及复发原因的研究分析

Analysis of Postoperative Complications and Recurrence Reason of Chronic Subdural Hematomas

目的:研究使用钻孔引流治疗慢性硬膜下血肿术后患者出现并发症的情况及复发原因。方法:回顾性分析我院2006年1月～2011年12月经钻孔引流术治疗的255例CSDH患者的临床资料,采用CT对CSDH患者进行扫描,对患者血肿进行分型,探讨研究哪些血肿易发生误诊及复发。调查患者术后治愈情况,分析研究并发症、复发原因及防治措施。结果:255例患者共治愈251例,4例死亡,死亡原因分别是弥散性血管内凝血1例、肺部感染2例及癫痫发作1例。并发症发生19例,其中,癫痫3例,脑卒中4例,血肿复发11例,张力性气颅1例。结论:采用钻孔闭式引流治疗CSDH较为安全,但仍存在一些并发症和复发情况,充分认识和预防这些并发症能进一步提高CSDH患者的治愈率,降低死亡率。

Objective：To research the postoperative complications after the use of hole drainage in patients with CSDH,and the reason of recurrence.Methods：Retrospective analyze the clinical material of 255 cases of patients with CSDH and treated with burr-hole craniostomy and irrigation with closed system drainage from January 2006 to December 2011 in our hospital.The diagnosis method for patients was CT scan,and patients with CSDH were divided into different type through the result of CT scan.Research what type of CSDH was easy to be misdiagnosed and recurrence.Analyze the occurrence of complications and recurrence,the cause of occurrence and how to prevent and treat.Results：251 cases in all 255 cases of CSDH patients were cured,and 4 cases died.The causes of death included diffuse intravascular coagulation（1cases）,pulmonary infection（2cases）and epilepsy（1cases）.There were totally 19 cases of complications,include 3 cases of epilepsy,4 cases of stroke,11 cases of recurrent hematoma and 1 case of tension disposition cranial.Conclusions：Although the treatment of CSDH with burr-hole craniostomy and irrigation with closed system drainage was a safe and simple method,postoperative complications might be encounted and motality still existed in some patients.