神经内镜与钻孔引流治疗大量慢性硬膜下血肿的疗效及安全性

Efficacy and safety of neuroendoscopy and borehole drainage in the treatment of massive chronic subdural hematoma

目的探讨神经内镜与钻孔引流治疗慢性硬膜下血肿(CSDH)的疗效及安全性。方法收集2020年1月至2022年12月我科收治的117例大量慢性硬膜下血肿患者的临床资料并进行回顾性分析,依据手术方法差异,将患者分为两组,内镜组52例,钻孔引流组65例。比较两组患者的一般情况、CT表现、临床疗效、术后并发症及3个月后复发情况。结果内镜组患者术后引流管留置时间以及住院时间更短,术后1周的血肿清除率更高(P<0.05);两组患者术后并发症发生率差异无统计学意义,内镜组患者3个月随访时预后更佳。结论神经内镜与钻孔引流均能有效治疗CSDH,同时神经内镜术后血肿清除率更高,留置引流管及住院时间短,在治疗慢性硬膜下血肿尤其是混杂密度血肿方面具有更好的临床疗效。

Objective To investigate the efficacy and safety of neuroendoscopy and borehole drainage in the treatment of chronic subdural hematoma(CSDH).Methods Clinical data of 117 CSDH patients hospitalized in our department during Jan.2020 and Dec.2022 were retrospectively analyzed.The patients were divided into two groups according to the surgical approaches,52 cases in the neuroendoscopic group and 65 cases in the borehole drainage group.The demography,CT imaging,clinical efficacy,postoperative complications and recurrence rate were compared between the two groups.Results Compared with the borehole drainage group,the neuroendoscopic group had a shorter drainage tube retention time and hospital stay,and higher hematoma clearance rate(P<0.05),but longer operation time.There was no significant difference in the incidence of postoperative complications between the two groups.The neuroendoscopic group had a better prognosis at the 3-month follow-up.Conclusion Both neuroendoscopy and borehole drainage can effectively treat CSDH,while neuroendoscopy has a higher hematoma clearance rate,shorter retention of drainage tube and hospital stay,and better clinical efficacy.