微创双针穿刺冲洗治疗慢性硬膜下血肿的效果分析

Analysis of the Effect of Minimally Invasive Double Needle Puncture and Irrigation in Treating Chronic Head Injury

目的探讨微创双针穿刺冲洗治疗慢性硬膜下血肿(subdural hematoma,CSDH)的临床疗效。方法回顾性分析我院应用两种方法治疗的232例慢性硬膜下血肿患者临床资料,应用微创穿刺双针冲洗治疗的116例为双针冲洗组,应用微创穿刺单针法治疗的116例为单针引流组,比较2组术后颅内积气、血肿清除时间、住院时间、医疗费用、格拉斯哥预后分级(GOS)等情况。结果双针冲洗组术后血肿清除率明显比单针穿刺组高,各组间比较差异显著(P<0.05)。双针冲洗组引流天数、住院天数均明显比单针穿刺组短(P均<0.05)。双针冲洗组颅内积气发生率比单针穿刺组发生率低(P<0.05),手术时间比较两者则无明显差异。预后GOS分级均无明显差异。结论微创穿刺双针冲洗治疗法比微创穿刺单针引流法在颅内积气、血肿基本清除时间、住院时间等方面更有优势,值得临床推广应用。

Objective To explore the clinical effect of minimally invasive double needle Puncture and irrigation in the treatment of chronic head injury(CSDH).Methods From January 2005 to December 2020,232 patients with chronic head injury were treated by double needle and single-needle aspiration.116 patients were treated by double needle aspiration,116 cases of single needle drainage were treated with minimally invasive puncture and single-needle drainage.Postoperative intracranial pneumatosis,Hematoma clearance time,hospital stay,medical expenses and Glasgow outcome scale(Gos)were compared between the two groups.Results Compared with single needle puncture group,the clearance time of postoperative Hematoma in double needle irrigation group was significantly faster than that in single needle puncture group(P<0.01).The duration of drainage and hospitalization in the two groups were significantly shorter than that in the single needle group(P<0.01).The incidence of pneumocephalus in double needle Irrigation Group was lower than that in single needle Puncture Group(χ2=19.27,P<0.01).There was no significant difference in operation time(χ2=1.31,P>0.05).There was no significant difference in GOS grade.Conclusion Minimally Invasive double needle aspiration therapy is more effective than minimally invasive single needle aspiration and drainage in the treatment of intracranial pneumatosis,hematoma basic clearance time,hospital stay time,etc.