神经内窥镜辅助手术治疗慢性硬膜下血肿

Neuroendoscopic assisted operation for chronic subdural hematoma

目的探讨内窥镜技术在慢性硬膜下血肿（CSDH）手术治疗中的价值。方法2008年1月～2012年12月，87例CSDH病人随机分为两组；内窥镜下冲洗引流组（n=42）和传统钻孔冲洗引流组（n=45），比较两组手术效果及术后并发症发生率。结果两组病例手术总有效率无显著差异，但两组恢复至Bender0级的比率分别为80．0％和95．2％（P〈0．05）。传统手术组血肿复发9例（20．0％），内窥镜组血肿复发2例（5％），两组问术后血肿复发率有显著差异（P〈0．05）。结论内窥镜下手术治疗CSDH，效果好，降低了术后血肿复发率。

Objective To explore the effects of the surgical treatment for chronic subdural hematoma （CSDH） under endoscope. Methods 87 patients with CSDH was divided into two groups . In one group of 42 patients, irrigation and drainage operation for CSDH was performed under endoscope through a burr hole approach. In another group of 45 patient as the control group, traditional irrigation and drainage operation for CSDH was performed without endoscope. Results There was no significant difference of total therapeutic efficacy in both groups. But in the group with and without endoscope, the rate of patients recovering to Bender scale 0 was 95.2% and 80.0% respectively （P 〈 0.05）. The number of postoperative hematoma recurrence was 2 cases（5% ） and 9 cases （20.0%） respectiwly （P 〈 0.05）. Conclusion The operation for CSDH under endoscope can improve the therapeutic efficacy and decrease the recurrence rate.