改良钻孔引流术对慢性硬膜下血肿患者术后硬膜下积液积气和远离术区颅内出血及近期预后的影响

Effects of Modified Borehole Drainage on Postoperative Intracranial Pneumatocele Remoteintracranial Hemorrhageand Short-term Prognosis in Patients with Chronic Subdural Hematoma

目的:探讨改良钻孔引流术对慢性硬膜下血肿患者术后硬膜下积液、积气和远离术区颅内出血及近期预后的影响。方法:选取2017年1月至2020年1月我院收治的120例慢性硬膜下血肿患者为研究对象,按随机数表法分为观察组(61例)和对照组(59例),其中对照组采取常规钻孔引流术治疗,观察组采取内镜辅助下钻孔引流术,比较两组患者一般手术指标、术后并发症发生情况、临床疗效以及术后1个月的预后结果。结果:两组患者手术时间比较无明显差异(P>0.05),观察组患者住院时间低于对照组患者(P<0.05);观察组患者术后硬膜下积液、积气以及远离术区颅内出血发生率均低于对照组(P<0.05),另外观察组脑组织复张情况也明显优于对照组(P<0.05);观察组临床总有效率为98.36%,明显高于对照组临床总有效率89.83%(P<0.05);术后1个月,观察组患者残疾率为1.64%,明显低于对照组患者残疾率10.17%(P<0.05);观察组患者复发率为1.64%,也明显低于对照组复发率11.86%(P<0.05)。结论:对慢性硬膜下血肿患者采取内镜辅助下钻孔引流术进行治疗,不仅有利于降低患者术后硬膜下积气、积液以及远离术区颅内出血发生率,另外还有利于患者脑组织复张更快恢复,在临床上具有更好疗效,同时还能降低术后复发率和残疾率,对改善患者预后具有一定积极意义,在临床上值得推广应用。

Objective:To explore the effects of modified borehole drainage on postoperative intracranial pneumatocele,remote intracranial hemorrhage and short-term prognosis in patients with chronic subdural hematoma.Methods:120 patients with chronic subdural hematomawhowere admitted to the hospital from January 2017 to January 2020 were enrolled as research objects.They were randomly divided into observation group(61 cases)and control group(59 cases)according to the random number table method.The control group was treated with routine boreholedrainage,while observation group was treated with endoscopic assisted drilling drainage,In addition,the brain tissue recruitment of the observation group was significantly better than that of the control group(P<0.05).The general surgical indexes,postoperative complications,clinical curative effect and prognosis results at 1 month after surgery were compared between the two groups.Results:There was no significant difference in operation time between the two groups(P>0.05).The hospitalization time in observation group was significantly shorter than that in control group(P<0.05),incidence of postoperative intracranial pneumatocele,intracranial effusion and remote intracranial hemorrhage was lower than that in control group(P<0.05),and total clinical response rate was significantly higher than that in control group(98.36%vs 89.83%)(P<0.05).At 1 month after surgery,disability rate in observation group was significantly lower than that in control group(1.64%vs 10.17%)(P<0.05),and recurrence rate was significantly lower than that in control group(1.64%vs 11.86%)(P<0.05).Conclusion:The application of endoscopic assisted drilling drainage in patients with chronic subdural hematoma is not only beneficial to reduce the incidence of postoperative intracranial pneumatocele,intracranial effusion and remote intracranial hemorrhage,In addition,it is conducive to the rapid recovery of brain tissue,with better clinical curative effect,but also can reduce Postoperativerecurrence rate and disability rate,which is of certain positive significance in improving prognosis of patients.