硬通道穿刺引流术治疗老年慢性硬脑膜下血肿的临床研究

Clinical Research on Hard Puncture Needle Passage Drainage in Treatment of Chronic Subdural Hematoma in Senile Patients

目的探究硬通道穿刺引流术治疗老年慢性脑膜下血肿临床效果。方法便利选取2014年8月—2015年8月该院收治的老年慢性硬脑膜下血肿的患者85例,随机分为传统钻孔引流术对照组(42例),硬通道穿刺引流术治疗观察组(43例),治疗后随访观察1年,观察组两组患者的手术效果,并发症和1年后患者复发情况。结果经过治疗后两组患者的症状均得到了改善,其中观察组患者的手术时间、住院时间分别为(29.01±3.52)min、(8.97±1.25)d,少于对照组的手术时间(67.26±18.64)min、住院时间(10.48±2.63)d,差异有统计学意义(P<0.05)。观察组患者的Bender分级的和日常生活能力分级情况明显优于对照组,差异有统计学意义(P<0.05)。观察组患者的并发症发生11例,占26.19%,明显优于对照组患者的并发症发生2例,占4.65%(P<0.05)。另外,观察组患者的复发1例,占2.32%,优于对照组患者的复发的10例,占23.26%,差异有统计学意义(P<0.05)。结论硬通道穿刺引流治疗老年慢性脑膜下血肿可有效改善患者临床症状,提高生活质量。且硬通道穿刺引流术治疗的创伤小,手术时间短,并发症发生几率低,效果显著,值得临床推广实践。

Objective To study the clinical effect of hard puncture needle passage drainage in treatment of chronic subdural hematoma in senile patients. Methods 85 cases of senile patients with chronic subdural hematoma admitted and treated in our hospital from August 2014 to August 2015 were convenient selected and randomly divided into two groups, the control group with 42 cases adopted the traditional cranial drilling hematoma evacuation drainage, while the observation group adopted the hard puncture needle passage drainage, after treatment, both groups were followed up for one year, and the operation effect, complications and recurrence situation of the two groups were observed. Results After treatment, the symptoms of the two groups were improved, and the operation time and length of stay in the observation group were fewer than those in the control group, [（29.01±3.52）min、（8.97±1.25）d vs（67.26±18.64）min,（10.48±2.63）d], and the differences were statistically significant（P〈0.05）, and the Bender grading and activities of daily living grading in the observation group were obviously better than those in the control group, and the differences were statistically significant（P〈0.05）, and the incidence rate of complications in the observation group was obviously better than that in the control group,（11 cases vs 2cases, 26.19% vs 4.65%）（P〈0.05）, besides, the recurrence rate in the observation group was better than that in the control group（1 case vs 10 cases, 2.32% vs 23.26%）, and the difference was statistically significant（P〈0.05）. Conclusion The hard puncture needle passage drainage in treatment of chronic subdural hematoma in senile patients can improve the clinical symptoms of patients and improve the quality of life with small wound, short operation time and low incidence rate of complications and the effect is obvious, which is worth clinical promotion and practice.