脑膜中动脉阻断对减少慢性硬膜下血肿引流术后复发的疗效观察

目的探讨小骨窗引流并患侧脑膜中动脉阻断治疗单侧慢性硬膜下血肿的疗效.方法2017年6月至2018年10月采用小骨窗引流并患侧脑膜中动脉阻断治疗患者30例为观察组,2016年1月至2017年6月采用单纯小骨窗引流术治疗的患者30例为对照组.比较两组患者血肿完全消散时间、血肿复发率、手术时间、住院时间、手术并发症、术后3个月mRS功能评分等情况.结果两组患者住院时间、手术并发症、术后3个月MRS功能评分差异无统计学意义(P>0.05);观察组患者术后血肿消退时间明显短于对照组[(25.17±7.87)dvs.(41.81±9.23)d;P<0.001],但观察组手术时间比对照组延长[(57.82±7.33)minvs.(52.23±6.78)min;P=0.003].观察组复发率低于对照组(P<0.05).结论对于单侧慢性硬膜下血肿患者,小骨窗引流血肿并行患侧脑膜中动脉阻断可有效缩短血肿清除时间,避免或减少血肿复发率.

Objective To elucidate effects of the method that combined burr-hole drainage with middle meningeal artery occlusion(MMAO)on treating unilateral chronic subdural hemorrhage(CSDH).Methods The unilateral CSDH patients were enrolled from People's Hospital of Haiyan County between January 2016 to October 2018.According different surgical methods,enrolled patients were dichotomized into treatment and control group.Patients in treatment group received burr-hole drainage combined with MMAO of affected side,while control patients received merely burr-hole drainage.Outcome of CSDH patients were assessed by periods of hematoma clearance,recurrent rates of CSDH,duration of operations,length of staying in hospital,3-month mRS(modified Rankin Scale)scores and et al.Results Sixty unilateral CSDH patients were included.No signific?int differences were observed in?ige,gender,history of he?id trauma and the density of hematoma between two groups(P>0.05).Moreover,the length of staying in hospital,operative complications rates,and 3-month mRS scores all showed no significant differences betAveen the two groups(P>0.05).Compared with the control group,the period of hematoma clearance was statistical shorter in treatment group(25.17±7.87 vs.41.81±9.23;P<0.001),however,the duration of operation was obviously longer in treatment group(57.82±7.33 vs.52.23±6.78;P=0.003).The recurrent rate of CSDH was higher in control than treatment group,with significantly differences(P<0.05).Conclusions In unilateral CSDH patients,the period of hematoma clearance may be shortened by applying burr-hole drainage accompanied with MMAO,and avoid or reduce the recurrence rate of hematoma.