改良钻孔引流术治疗慢性硬膜下血肿的效果观察

Observation of effects of modified drilling and drainage on chronic subdural hematoma

目的探讨改良钻孔引流术治疗慢性硬膜下血肿(CSDH)的效果。方法队列研究。抽取2019年1月至2023年8月洛阳市第三人民医院收治的CSDH患者62例,根据治疗方式分为对照组(32例)与研究组(30例)。研究组采用改良钻孔引流术治疗,对照组采用常规钻孔引流术治疗。比较两组临床疗效、围术期指标、手术前后炎性指标[C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]及并发症发生率。结果研究组临床有效率(93.4%,28/30)高于对照组(62.5%,20/32),P<0.05。术后,研究组手术时间、住院时间及拔管时间均短于对照组(P均<0.05);术后,两组血清CRP、TNF-α水平均较术前降低,且研究组血清CRP、TNF-α水平低于对照组(P<0.05)。术后,研究组并发症发生率(9.9%,3/30)低于对照组(34.4%,11/32),P<0.05。结论改良钻孔引流术对CSDH患者的疗效更佳,同时可减轻其炎性反应程度,并降低术后并发症发生率。

Objective To investigate the effects of modified drilling and drainage on chronic subdural hematoma(CSDH).Methods A total of 62 patients with CSDH admitted to the Third People’s Hospital of Luoyang from January 2019 to August 2023 were selected for the cohort study.And they were divided into a control group(32 cases)and a study group(30 cases)according to the treatment method.The study group was treated by modified drilling and drainage,while the control group was treated by conventional drilling and drainage.The clinical efficacy,perioperative indicators,preoperative and postoperative inflammatory indicators,including C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α),and the incidence of complications were compared between the two groups.Results The effective rate of the study group(93.4%,28/30)was higher than that of the control group(62.5%,20/32),P<0.05.The operation time,hospital stay and extubation time of the study group were shorter than those of the control group after surgery(all P<0.05).After operation,the levels of serum CRP and TNF-αin both groups were lower than those before operation,and the levels of serum CRP and TNF-αin the study group were lower than those in the control group(P<0.05).The overall incidence of postoperative complication in the study group(9.9%,3/30)was lower than that in the control group(34.4%,11/32),P<0.05.Conclusions The modified drilling and drainage is more effective in the treatment of CSDH;it can reduce the degree of inflammatory response,and reduce the incidence of postoperative complications.