灌洗液温度对慢性硬膜下血肿钻孔引流术疗效的影响

Effect of irrigation fluid temperature on the efficacy of burr hole drainage for patients with chronic subdural hematoma

目的探讨灌洗液温度对慢性硬膜下血肿(CSDH)钻孔引流术疗效的影响。方法回顾性分析2019年9月至2022年9月钻孔引流术治疗的130例幕上单侧CSDH的临床资料。术中均使用生理盐水行血肿腔灌洗操作,其中65例使用体温灌洗液(37℃,体温组),65例使用室温灌洗液(20℃,室温组),观察两组术后2周手术相关并发症情况以及术后3个月血肿复发、改良Rankin量表(mRS)评分。结果体温组术后2周手术相关硬膜下积液发生率(7.7%,5/65)与室温组(9.2%,6/65)无统计学差异(P=0.753)。体温组术后3个月血肿复发率(7.7%,5/65)明显低于室温组(20.0%,13/65;P=0.042)。体温组术后3个月mRS评分[(1.52±1.35)分]明显优于室温组[(2.43±1.44)分;P<0.001]。结论钻孔引流术治疗CSDH时,术中采用接近体温的灌洗液更有利于血肿引流,可减少术后血肿复发率,改善病人的预后。

Objective To investigate the influence of irrigation fluid temperature on the efficacy of burr hole drainage for patients with chronic subdural hematoma(CSDH).Methods A retrospective analysis was conducted on the clinical of 130 patients with unilateral supratentorial CSDH treated by burr hole drainage from September 2019 to September 2022.Normal saline was used for hematoma cavity irrigation during the surgery,with 65 patients using body temperature saline(37℃,body temperature group)and 65 patients using room temperature saline(20℃,room temperature group).The incidence of surgical-related complications within 2 weeks after the operation,and the recurrence of hematoma and the modified Rankin Scale(mRS)score 3 months after the operation were observed in both groups.Results The incidence of subdural effusion within 2 weeks after the surgery in the body temperature group(7.7%,5/65)was not statistically different from that(9.2%,6/65)in the room temperature group(P=0.753).The recurrence rate of hematoma in the body temperature group(7.7%,5/65)was significantly lower than that(20.0%,13/65)in the room temperature group(P=0.042).The mRS score in the body temperature group(1.52±1.35)was significantly lower than that(2.43±1.44)in the room temperature group(P<0.001).Conclusions For patients with unilateral supratentorial CSDH undergoing burr hole drainage,the use of lavage solution close to body temperature is helpful to hematoma drainage,reducing the postoperative hematoma recurrence rate and improving the prognosis of patients.