不同术式对急性外伤性硬膜下血肿临床疗效及预后的影响

Effect of different surgical procedures on clinical efficacy and prognosis of acute traumatic subdural hematoma

目的探讨颅脑损伤后急性硬膜下血肿的最佳治疗策略。方法回顾性分析我院2015年1月～2017年10月收治的114例ASDH患者的临床资料,按照手术方式分为血肿清除还纳骨瓣术(craniotomy,CO)组和血肿清除去骨瓣减压术(decompressive craniectomy,DC)组,分析两组患者的临床特征、术后并发症和预后。结果 CO组66例(57.9%),DC组48例(42.1%),与CO组患者相比,DC组患者年龄较小(χ~2=13.84,P<0.05),其他术前临床特点和CT扫描特征差异均无统计学意义(P>0.05),DC组患者具有更高的住院死亡率、更差的预后和更多的新发血肿(P<0.05)。结论考虑到DC患者的术后并发症时,CO也是一种可取的治疗ASDH安全有效的手术方式,值得临床应用和推广。

Objective To explore the optimal treatment strategy for acute subdural hematoma （ASDH） after eranioeere- bral injury. Methods The clinical data of 114 patients with ASDH admitted in our hospital from January 2015 to Octo- ber 2017 were retrospectively analyzed. According to the surgical procedure, the patients were divided into eraniotomy （CO） group and the hematoma removal deeompressive eranieetomy （DC） group. The clinical features, postoperative com- plications and prognosis between the two groups were analyzed. Results There were 66 patients（57.9%） in the CO group and 48 patients （42.1%） in the DC group. The patients in the DC group were younger than those in the CO group （X2= 13.84, P〈0.05）. There were no significant differences in other preoperative clinical features and CT scan features（P〉0.05）. Patients in the DC group had higher hospital mortality, worse prognosis, and more new hematomas（P〈0.05）. Conclusion Considering CO is also a safe and effective surgical method for the treatment of ASDH in the postoperative complica- tions of DC patients, it is worthy of clinical application and promotion.