颅内血肿硬通道穿刺引流治疗慢性硬膜下血肿临床观察

Clinical observation of intracranial hematoma hard channel puncture and drainage for the treatment of chronic subdural hematoma

目的分析颅内血肿硬通道穿刺引流治疗慢性硬膜下血肿的手术学疗效及对预后的影响。方法纳入2016-03—2019-08皖北煤电集团总医院收治的80例慢性硬膜下血肿患者,对照组40例予以颅内血肿钻孔穿刺引流术,试验组40例予以颅内血肿硬通道穿刺引流术,对比分析2组患者的围术期指标、临床疗效、日常生活活动能力及预后情况。结果试验组患者的手术切口长度、手术操作时间分别为(0.43±0.16)cm与(26.49±9.16)min,均优于对照组的(3.59±1.17)cm及(55.66±17.29)min;试验组术中失血量(9.63±2.46)mL,较对照组的(47.29±20.11)mL少,差异均有统计学意义(P<0.05)。手术治疗后,试验组患者总有效率95.00%,对照组为75.00%,2组对比差异有统计学意义(P<0.05)。试验组日常生活活动量表(ADL)评分(89.62±6.66)分,较对照组的(77.27±5.61)分高,差异有统计学意义(P<0.05)。试验组4例出现并发症,1例血肿复发,而对照组12例出现并发症,6例血肿复发,2组对比差异有统计学意义(P<0.05)。结论颅内血肿硬通道穿刺引流治疗慢性硬膜下血肿的疗效显著,有助于改善患者围术期指标及日常生活活动能力,提升预后。

Objective To analyze the operative effect of intracranial hematoma hard channel puncture and drainage for chronic subdural hematoma.Methods Totally 80 cases of chronic subdural hematoma patients who were admitted to our hospital from March 2016 to August 2019 as the objects,and randomly divided into two groups according to the computer digital table method.Forty cases in the control group were treated with intracranial hematoma drilling puncture and drainage,40 cases of patients in the experimental group were treated with intracranial hematoma hard channel puncture and drainage,the perioperative indicators,clinical efficacy,daily life activities and prognosis level were compared and analyzed between the two groups.Results The surgical incision length and operation time of the experimental group were(0.43±0.16)cm and(26.49±9.16)minutes,respectively,which were shorter than those in the control group(3.59±1.17)cm and(55.66±17.29)minutes,and the blood loss in the test group was(9.63±2.46)mL,which was less than(47.29±20.11)mL in the control group,with statistically significant(P<0.05).After surgical treatment,the total effective rate of patients in the experimental group was 95.00%,and the total effective rate of the control group was 75.00%.The difference between the two groups was statistically significant(P<0.05).In the experimental group,the ADL score was(89.62±6.66)points,which was higher than(77.27±5.61)points in the control group,with statistically significant(P<0.05).Follow-up so far,there were 4 cases of complications and 1 case of hematoma recurrence in the experimental group,while there were 12 cases of complications and 6 cases of hematoma recurrence in the control group,the difference between the two groups was statistically significant(P<0.05).Conclusion Intracranial hematoma hard channel puncture and drainage has a significant effect on the treatment of chronic subdural hematoma,which can help to improve the perioperative indicators of daily living activities of patients,as well as improve their prognosis.