一种新型封闭式钻孔引流术治疗慢性硬膜下血肿的临床疗效初步观察

Clinical effect of a new closed irrigation and drainage technique for surgical evacuation of chronic subdural haematomas

目的观察慢性硬膜下血肿(CSDH)患者行单骨孔封闭冲洗及骨膜下引流术的疗效。方法选取江阴市人民医院神经外科自2017年1月至2019年6月收治的CSDH患者106例,分为常规单骨孔钻孔引流术组(常规组)和单骨孔封闭冲洗及骨膜下引流术组(封闭组),对2组患者的手术疗效及并发症进行统计分析。结果2组患者的手术疗效比较差异无统计学意义(Z=0.262,P>0.05);封闭组术后颅内积气量明显低于常规组,差异有统计学意义(Z=3.963,P<0.05);2组患者术后症状性气颅、脑损伤、切口脑脊液漏、癫痫发作、血肿复发的发生率比较差异无统计学意义(P>0.05)。结论单骨孔封闭冲洗及骨膜下引流术治疗CSDH能明显降低术后颅内积气,是一种简单、有效、安全的治疗手段。

Objective To observe the clinical effect of single burr-hole irrigation and continuous closed sub-periosteal drainage in patients with chronic subdural hematoma(CSDH).Methods A total of 106 patients with CSDH admitted to Department of Neurosurgery,Jiangyin People’s Hospital from January 2017 to June 2019 were divided into the conventional single bone hole drilling and drainage group(conventional group)and the single burr-hole irrigation and continuous closed sub-periosteal drainage group(closed group).The surgical efficacy and complications of the two groups were statistically analyzed.Results There was no statistically significant difference in surgical efficacy between the two groups(Z=0.262,P>0.05).The intracranial pneumatocele in closed group was significantly less than that in conventional group(Z=3.963,P<0.05).There was no significant difference in the incidence of postoperative symptomatic pneumocephalus,brain injury,cerebrospinal fluid leakage,epilepsy and hematoma recurrence between the two groups(P>0.05).Conclusion The treatment of CSDH by single burr-hole irrigation and continuous closed sub-periosteal drainage can significantly reduce the intracranial pneumatocele after operation,which is a simple,effective and safe treatment method.