慢性硬膜下血肿的手术治疗

Surgical management of chronic subdural hematoma

目的 :总结慢性硬膜下血肿手术治疗的经验及疗效。方法 :回顾性分析 15 6例慢性硬膜下血肿患者的临床及神经影像学特征、手术方法和经验。结果 :15 6例患者均采用钻孔冲洗引流术 ,其中 10例患者改行开颅血肿清除术。 14 3例治愈 ,8例术后症状无改善 ,经原钻孔再次引流手术后治愈 ,3例因引流管移位进入脑组织致术后出现偏瘫或偏瘫加重 ,2例术后 1月内死于其它疾病。结论 :慢性硬膜下血肿的首选方法是钻孔引流术 ,对于包膜肥厚或血肿尚未完全液化者 。

Objective To report the experience of surgical treatment of chronic subdural hematoma (CSDH). Methods The clinical features, radiological findings, operative techniques and outcome of 156 patients with CSDH were analysized retrospectively. Results All the patients (156) were initially treated by burr hole craniostomy with closed system drainage, and 10 out of the 156 patients were reoperated by larger craniotomy. Of all the patients, 143 (91.7%) were cured, 8 (5.1%) had recurrence, 3 (1.9%) got hemiparalysis, and 2 (1.3%) died due to other diseases. Conclusion Burr hole craniostomy with closed system drainage is effective for the initial treatment of CSDH. Craniotomy should be carried out only in patients with accumuating hematomas.