急性硬膜下血肿选择性保守治疗分析

Analysis of Selective Conservative Treatment of Acute Subdural Hematoma

目的探讨急性硬膜下血肿选择性保守治疗体会。方法根据2017年1月-2019年6月治疗的急性硬膜下血肿患者120例作为研究对象,根据入院时间顺序的奇偶性分为对照组(n=60)和观察组(n=60)。对照组给予入院时进行保守治疗的方式进行监测,观察组进行手术的方式进行治疗,之后对患者的治疗效果进行评估,比较两组的转归影响因素指标分析和血肿厚度、中线移位、消散时间、液化吸收时间指标。结果两组患者在性别和年龄方面比较均差异无统计学意义(P>0.05);两组患者治疗方式相比,手术治疗组最大血肿厚度、GCS评分、、合并其他脑外伤方面,差异有统计学意义(t=5.499、5.042、5.492,P<0.05);经两组治疗方式显示表明:两组患者中线移位值(0.35±0.01)cm和(0.32±0.06)cm,血肿消散时间(8.59±0.10)h和(8.38±0.09)h,差异无统计学意义(t=0.596、0.435,P>0.05),观察组患者血肿厚度(0.88±0.08)cm和血肿消散时间(13.43±1.20)h,数据均高于对照组患者,差异有统计学意义(t=4.116、3.753,P<0.05)。结论将急性硬膜下血肿患者在入院后进行保守性治疗,时刻关注患者病情,根据具体病情选择手术治疗,可避免患者不必要的手术创伤,值得推广应用。

Objective To explore the experience of selective conservative treatment of acute subdural hematoma.Methods select 120 pa-tients with acute subdural hematoma treated from January 2017 to June 2019 as the research objects,they were divided into the con-trol group(n=60)and the observation group(n=60)according to the parity of admission time sequence.The control group was monitored by conservative treatment on admission,and the observation group was treated by surgery.Afterwards,the patient’s treatment effect was evaluated,and the outcome of the two groups was compared with the analysis of factors affecting the outcome of the two groups and the thickness of the hematoma,midline shift,and dissipation time,liquefaction absorption time index.Results All patients with acute subdural hematoma were not statistically significant in terms of gender and age(P>0.05);compared with the treatment methods of the two groups,the maximum thickness of the hematoma,the GCS score,the presence or absence of other brain trauma,the difference was statistically significant(t=5.499,5.042,5.492,P<0.05);The display of the two groups of treatment methods showed that:the median line shift value of the two groups was(0.35±0.01)cm and(0.32±0.06)cm,hematoma dissipation time(8.59±0.10)h and(8.38±0.09)h,the difference was not statistically significant(t=0.596,0.435,P>0.05).The thickness of the hematoma in the observation group was(0.88±0.08)cm and the Liquefaction absorption time(13.43±1.20)h,and the data were all higher than the control group,the difference was statistically significant(t=4.116,3.753,P<0.05).Conclusion Conservative treatment of patients with acute subdural hematoma after admission,always pay attention to the patient’s condition,choose surgical treatment according to the specific condition,can avoid unnecessary surgical trauma,and is worthy of promotion and application.