帽状腱膜下引流治疗慢性硬脑膜下血肿的疗效分析

Efficacy of subgaleal drainage in treatment of chronic subdural hematoma

目的探讨帽状腱膜下引流治疗慢性硬脑膜下血肿(CSDH)的有效性及安全性。方法选取2015年1月—2019年12月中南大学湘雅医学院附属海口医院收治的82例帽状腱膜(实验组)和98例硬脑膜下(对照组)引流的CSDH患者,分析其术后并发症发生率、随访期内血肿复发、预后及硬脑膜下血肿/积液情况。结果实验组与对照组患者术前、拔管前及6个月复查血肿/积液厚度比较:①两组血肿/积液厚度有差异(F=1.684,P=0.000);②实验组与对照组血肿/积液厚度无差异(F=0.277,P=0.758);③两组的血肿/积液厚度变化趋势无差异(F=2.164,P=0.142)。实验组手术时间短于对照组(P<0.05)。两组患者二次手术、术后感染、癫痫发作、死亡率、随访期内复发率及6个月来院复查MRS评分情况比较,差异无统计学意义(P>0.05)。实验组皮层损伤率低于对照组(P>0.05)。结论帽状腱膜与硬脑膜下引流临床疗效相当,且手术时间更短,更简便、安全,具有临床应用潜力。

Objective To investigate the efficacy and safety of subgaleal drainage as a therapeutic strategy of chronic subdural hematoma.Methods The incidence of postoperative complications,hematoma recurrence,prognosis,and subdural hematoma were analyzed in 98 patients with subdural drainage and 82 patients with subgaleal drainage during the follow-up period from January 2015 to December 2019 in our hospital.Results There were differences in the postoperative cerebral cortex injury rate between the two groups(P<0.05),both groups showed decrease of hematoma thickness(P<0.05),indicated the same efficacy of hematoma resolution in two groups(P>0.05),however subgaleal drainage took less time in operation(P<0.05).And there were no statistically significant differences in the second operation,postoperative infection,epileptic seizure,mortality,hematoma recurrence and MRS score at 6 months after surgery(P>0.05).Conclusions Subgaleal drainage has the same effect as subdural drainage in the treatment of chronic subdural hematoma,but subgaleal drainage performs more simply and safety,and shows the potential in clinical therapy of chronic subdural hematoma.