持续引流联合佩戴自制弹力帽治疗去骨瓣减压术后手术侧皮下/硬膜下积液疗效分析

Analysis on the efficacy of percutaneous puncture and continuous drainage combined with self-made wearing elastic cap in treatment of subcutaneous hydrops or subdural effusion in the operation side after decompressive craniectomy

目的观察经皮穿刺持续引流联合佩戴自制弹力帽治疗去骨瓣减压术后手术侧皮下/硬膜下积液患者的临床疗效。方法将88例去骨瓣减压术后手术侧皮下/硬膜下积液患者采用单双号法分为联合组(44例)和对照组(44例),联合组患者实施经皮穿刺持续引流联合佩戴自制弹力帽治疗,对照组患者实施单纯经皮穿刺持续引流治疗,观察两组患者的皮下/硬膜下积液消失时间、住院时间、治疗过程中的并发症发生率以及拔管后的疾病复发情况。结果联合组患者的皮下/硬膜下积液消失时间早于对照组患者(3.6±1.1 d vs.6.1±1.3 d),住院时间短于对照组患者(9.1±1.9 d vs.12.2±2.3 d),拔管后的积液复发率(2.3%vs.13.6%)均低于对照组患者,两组上述指标比较差异均具有统计学意义(P<0.05)。两组治疗过程中的并发症发生率比较无显著差异(4.5%vs.6.9%)(P>0.05)。联合组拔管后复发率明显低于对照组(2.3%vs.13.6%),差异有显著性(P<0.05)。结论持续引流联合佩戴自制弹力帽用于治疗去骨瓣减压术后手术侧皮下/硬膜下积液患者,疗效确切,复发率低,并发症少,可作为现阶段临床治疗该疾病患者的首选方案。

Objective To observe the clinical effect of percutaneous puncture and continuous drainage combined with wearing self-made elastic cap in treatment of patients with subcutaneous hydrops or subdural effusion in the operation side after decompressive craniectomy.Methods A total of 88 patients with subcutaneous hydrops or subdural effusion in the operation side after decompressive craniectomy were divided into combination group （44 cases） and control group （44 cases） by the method of odd or even number.Patients in combination group were treated by percutaneous puncture and continuous drainage combined with wearing self-made elastic cap, and patients in control group were treated by simple percutaneous puncture and continuous drainage, the duration for disappearance of subcutaneous hydrops or subdural effusion, hospital stay, the incidence rate of complications, and the recurrence rate after pulling out the tube were observed between these two groups.Results Subcutaneous hydrops or subdural effusion in patients of combination group disappeared earlier than those of control group （3.6±1.1 d vs.6.1±1.3 d）, the duration of hospital stay was shorter than that of control group （9.1±1.9 d vs.12.2±2.3 d）, and the recurrence rate after pulling out of the tube was lower than that of patients in control group （2.3% vs.13.6%）, and the difference in paramerers between these two groups had statistical significance （P〈0.05）.However, the incidence rate of complications between these two groups had no significant difference （4.5% vs.6.9%） （P〉0.05）.The recurrence rate after pulling out of the tube in combination group was significantly lower than that of control group （2.3% vs 13.6%）, there was significant difference （P〈0.05）.Conclusion The efficacy of treatment for subcutaneous hydrops or subdural effusion in the operation side after decompressive craniectomy by percutaneous puncture and continuous drainage combined with wearing self-made elastic cap was definite, with lower recurrence rate and fewer complications, so it can be used as the prefered solution for treatment of this disease.