慢性硬膜下血肿36例手术治疗体会

Chronic subdural hematoma,36 cases of the surgical treatment experience

目的观察局麻+监护下颅骨钻孔(单孔)血肿腔外引流术治疗慢性硬膜下血肿的疗效。方法回顾性分析我院2005年6月—2012年5月经颅脑CT及MRI诊断明确为慢性硬膜下血肿患者36例,实施钻孔引流术的情况。结果 36例慢性硬膜下血肿患者实施颅骨钻孔血肿腔外引流术后,临床症状消失30例,症状改善6例,住院时间7 d^15 d,平均9 d,无1例死亡。2 d^14 d复查CT,36例血肿均消失,8例颅内少量积气、积液,无1例复发。结论慢性硬膜下血肿微创引流术操作简单,创伤小,手术时间短,痛苦轻,恢复快,费用低,疗效佳,适合在基层医院开展。

Objective study the outcomes of 36 chronic subdural hematoma cases which were treated by BHID.Methods in this study,we selected 36 patients with a CT scan-confirmed chronic subdural hematoma who were treated with Burr holes irrigation drainage（BHID）during 2005 June to 2012 May.The outcome of BHID was assessed based on the results of CT scan and patients’ clinical manifestations.A statistical analysis has been conducted.Results We found that,after a 7-15 days postoperative hospitalization time（mean time ：9 d）,30 out of 36 were relieved from symptoms and 6 were improved.A second CT scan has been done between 2-14 days post-op which showed that all the patients were relieved from hematoma,while,8 patients showed mild pneumoencephalos and/or hydrocephalus.But none relapsed.Conclusion BHID is a surgical procedure with the advantages of easy manipulation,less invasion,shorted OR time and recover time,cost effective procedure and good prognosis,which is a suitable option for primary medical centers to use.