慢性硬膜下血肿钻孔后骨膜下持续引流对并发症与预后的影响

Influence of Continuous Subperiosteal Drainage After Drilling of Chronic Subdural Hematoma on Complication and Prognosis

目的探究慢性硬膜下血肿钻孔后骨膜下持续引流对并发症及预后的影响。方法选取2019年1月至2020年5月河南大学第一附属医院收治的96例慢性硬膜下血肿的患者为研究对象,按随机数字表法分为观察组(48例)和对照组(48例)。观察组患者接受骨膜下引流,对照组患者接受硬膜下引流,观察比较两组患者治疗前后的血肿量、并发症发生率、短期预后及长期预后的差异。结果两组患者在持续引流下,血肿量较治疗前均有下降趋势,且观察组血肿量少于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率(8.33%)低于对照组(27.08%),差异有统计学意义(P<0.05);观察组患者再手术率、术后出血率及出院前残余血肿量与对照组比较,差异无统计学意义(P>0.05);观察组患者术后感染发生率、术后2 d颅内积气量低于对照组,住院时间短于对照组,差异有统计学意义(P<0.05);观察组患者在术后3、6、12个月复发率均低于对照组,差异有统计学意义(P<0.05)。结论慢性硬膜下血肿行骨膜下持续引流对患者腔内的血肿具有更好的清除力,能减轻对患者的伤害,降低并发症的发生,改善预后。

Objective To explore the influence of continuous subperiosteal drainage on complication and prognosis of chronic subdural hematoma after drilling.Methods Ninety-six patients with chronic subdural hematoma admitted to the First Affiliated Hospital of Henan University from January 2019 to May 2020 were selected as the research objects.Patients were divided into observation group and control group by random number table method,with 48 patients in each group.Observation group patients received subperiosteal drainage,and control group patients received subdural drainage.The differences in hematoma volume,complication rate,short-term prognosis and long-term prognosis were observed and compared between the two groups before and after treatment.Results Under continuous drainage,the amount of hematoma in the two groups had a decreasing trend compared with before treatment,and the amount of hematoma in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group(8.33%) was lower than that in the control group(27.08%),and the difference was statistically significant(P<0.05).The reoperation rate,the postoperative bleeding rate and residual hematoma volume before discharge of the observation group compared with control group,there were not statistically significant differences(P>0.05).The incidence of postoperative infection and intracranial volume 2 d after operation in the observation group were lower than those in the control group,and the hospital time was shorter,with statistical significance(P<0.05).The recurrence rate of observation group was lower than that of control group at 3,6 and 12 months after operation,with statistical significance(P<0.05).Conclusion Continuous subperiosteal drainage for chronic subdural hematoma has better clearance ability for intracavitary hematoma,alleviates the injury to patients,reduces the incidence of complications and improves the prognosis.