钻孔冲洗引流术治疗老年慢性硬脑膜下血肿的效果分析

Analysis of the Effect of Burr Hole Irrigation and Drainage in the Treatment of Chronic Subdural Hematoma in the Elderly

目的:探讨钻孔冲洗引流术治疗老年慢性硬脑膜下血肿患者的效果。方法:选择龙南市第一人民医院神经外科2019年4月—2022年4月收治的80例老年慢性硬脑膜下血肿患者,按照不同手术方式分组:采取锥孔引流术治疗为A组、钻孔冲洗引流术治疗为B组,各40例。对比疗效,包括临床总有效率、手术相关指标、炎症因子、复发率,同时采用美国国立卫生研究院卒中量表(NIHSS)评价患者神经功能缺损程度。结果:B组临床总有效率为95.00%较A组的75.00%高,差异有统计学意义(P<0.05)。B组手术时间较A组短,术中出血量少于A组,NIHSS评分、血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平均低于A组,差异均有统计学意义(P<0.05)。B组术后并发症发生率5.00%低于A组的20.00%,复发率2.50%低于A组的20.00%,差异有统计学意义(P<0.05)。结论:钻孔冲洗引流术近远期效果显著,且安全性高,利于减轻患者炎症反应、神经功能受损程度,降低复发率。

Objective:To explore the treatment of chronic subdural hematoma in elderly patients with burr hole irrigation and drainage.Method:A total of 80 elderly patients with chronic subdural hematoma who were admitted to the Neurosurgery Department of Longnan First People's Hospital from April 2019 to April 2022 were selected for research,they were divided into groups according to different surgical methods:patients who received conical drainage surgery were divided into group A,patients treated with burr hole irrigation and drainage were divided into group B,with 40 cases in each group.The curative effects were compared,including the clinical total effective rate,surgery-related indicators,inflammatory factors,recurrence rate,and the neurological function degree of defect of the patients was evaluated by the national institute of health stroke scale(NIHSS).Result:The total clinical effective rate of group B was 95.00%,which was higher than 75.00% of group A,the difference was statistically significant(P<0.05).The operation time of group B was shorter than that of group A,and the intraoperative blood loss was less than that of group A,NIHSS score,the levels of serum interleukin-6(IL-6),interleukin-10(IL-10),and tumor necrosis factor-α(TNF-α)were lower than those in group A,the differences were statistically significant(P<0.05).The complication rate was 5.00% of group B,which was lower than 20.00% of group A,and the recurrence rate was 2.50%,which was lower than 20.00% of group A,the differences were statistically significant(P<0.05).Conclusion:Burr hole irrigation and drainage has significant short-term and long-term effects and high safety,it is beneficial to reduce the degree of inflammatory response and neurological damage in patients,and reduce the recurrence rate.