单、双钻孔引流在慢性硬膜下血肿中的临床效果及对预后和复发的影响

Clinical Effect of Single and Double Trepanation Drainage in Chronic Subdural Hematoma and its Effect on Prognosis and Recurrence

目的研究单、双钻孔引流在慢性硬膜下血肿中的临床效果及对预后和复发的影响。方法选取2020年1月-2022年1月我院诊治的64例慢性硬膜下血肿患者为研究对象,采用随机数字表法分为对照组(n=32)和观察组(n=32)。对照组采用单钻孔引流术,观察组采用双钻孔引流术,比较两组临床手术指标(手术时间、引流时间以及住院时间)、临床效果、脑卒中mRs评分、神经功能缺损评分(Markwalder)、血肿量变化率、并发症发生率以及复发率。结果观察组手术时间长于对照组,引流时间、住院时间均短于对照组(P<0.05);观察组治疗总有效率为93.75%,高于对照组的78.12%(P<0.05);两组治疗后mRs评分、Markwalder评分均低于治疗前(P<0.05),但两组组间比较,差异无统计学意义(P>0.05);观察组血肿量变化率大于对照组(P<0.05);观察组并发症发生率为9.38%,低于对照组的21.88%(P<0.05);随访6个月,观察组复发率为3.13%,低于对照组的12.50%(P<0.05)。结论单、双钻孔引流治疗慢性硬膜下血肿均具有一定的疗效,但相对而言,双钻孔引流术临床效果更佳,血肿引流量更大,且可缩短住院时间、引流时间,降低复发率和并发症发生率,改善患者预后。

Objective To study the clinical effect of single and double trepanation drainage in chronic subdural hematoma and its effect on prognosis and recurrence.Methods A total of 64 patients with chronic subdural hematoma diagnosed and treated in our hospital from January 2020 to January 2022 were selected as the research objects.They were divided into control group(n=32)and observation group(n=32)by random number table method.The control group was treated with single trepanation drainage,and the observation group was treated with double trepanation drainage.The clinical operation indexes(operation time,drainage time and hospitalization time),clinical effect,stroke mRs score,neurological deficit score(Markwalder),hematoma volume change rate,complication rate and recurrence rate were compared between the two groups.Results The operation time of the observation group was longer than that of the control group,and the drainage time and hospitalization time were shorter than those of the control group(P<0.05).The total effective rate of treatment in the observation group was 93.75%,which was higher than 78.12%in the control group(P<0.05).The mRs score and Markwalder score of the two groups after treatment were lower than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).The change rate of hematoma volume in the observation group was higher than that in the control group(P<0.05).The incidence of complications in the observation group was 9.38%,which was lower than 21.88%in the control group(P<0.05).After 6 months of follow-up,the recurrence rate of the observation group was 3.13%,which was lower than 12.50%of the control group(P<0.05).Conclusion Both single and double trepanation drainage are effective in the treatment of chronic subdural hematoma,but double trepanation drainage is more effective and the amount of hematoma drainage is larger,it can shorten the time of hospitalization and drainage,reduce the rate of recurrence and complication,and improve the prognosis of the patients.