钻单孔与钻双孔冲洗引流术治疗慢性硬脑膜下血肿效果观察

Observation of single-hole and double-hole drainage in the treatment of chronic subdural hematoma

目的对比观察钻单孔与钻双孔冲洗引流术对慢性硬脑膜下血肿(chronic subdural hematoma,CSDH)的治疗效果。方法将90例CSDH患者随机分为对照组和观察组,各45例,观察组采用钻单孔冲洗引流术,对照组采用钻双孔冲洗引流术,观察对比两组治疗效果。结果观察组治愈32例(71.1%),手术时间(42.6±6.4)min,术后头痛11例,颅内积气23例,血肿复发6例;对照组治愈34例(75.6%),手术时间(71.8±12.5)min,术后头痛10例,颅内积气19例,血肿复发4例。对照组手术时间长于观察组(P<0.01),两组治愈率、头痛、颅内积气和血肿复发率无显著差异(P>0.05)。结论两种钻孔冲洗引流术对CSDH均有较好疗效,治疗效果无显著差异,但钻单孔冲洗引流术耗时较短、操作简便,更值得临床推广。

Objective To compare and observe the therapeutic efficacy of single-hole （SH） and double-hole（DH） drainage in the treatment of chronic subdural hematoma（CSDH）. Methods Ninety patients with CSDH were equally divided into control group in which the patients were treated with DH drainage and observation group in which the patients were treated with SH drainage. The curative effects of the patients in both groups were observed. Results Thirty-two patients（71.1% ）in the observation group whose av-erage operation time was（42.6 ±6.4） rain got cured, in which there were 11 patients with headache, 23 patients with intracranial pneumatocele and 6 patients with palindromia. Thirty-four patients （75.6%） in the control group whose average operation time was （ 71.8 ± 12.5 ） min got cured, in which there were 10 patients with headache, 19 patients with intracranial pneumatocele and 4 patients with patindromia. The operation time of the patients in the control group was obviously longer than that of the patients in the observation group（ P 〈 0.01 ）. The cure rate,headache rate,intracranial pneumatocele rate and palindromia rate of the patients in both groups had no significant differences（ P 〉 0.05）. Conclusion Both drilling and drainage methods in the treatment of CSDH which have better curative effects have no significant differences in therapeutic efficacy, while single-hole drainage which takes shorter time and has the advantage of easy operation is worth generalizing.