双侧慢性硬膜下血肿的诊治

Diagnosis and Treatment of Bilateral Chronic Subdural Hematoma

目的探讨双侧慢性硬膜下血肿(BCSDH)的诊断和治疗的特殊性。方法对我科自1988～1998年共收治的32例BCSDH病人的资料进行回顾性分析。这32例病人中5例行单侧钻孔引流,27例行双侧钻孔引流。结果治愈30例,1例原有神经系统功能不良,恢复不明显,1例死于结肠癌合并症。结论引流方法、血肿腔的处理和气颅的预防等使得治疗BCSDH的情况比较复杂,由于起病的原因不同,导致预后差异。

Objective To explore particularity of the diagnosis and treatment in the patients with bilateral chronic subdural hematomas (BCSDH).Methods The clinical data of 32 patients with BCSDH treated in our hospital from 1988 to 1998 were analyzed retrospectively.Of 32 patients with BCSDH,5 were treated by drainage through the unilateral trephined hole and 27 through the bilateral trephined hole.Results Of 32 patients with BCSDH,30 were completely cured.1 who had neurological disfunction before the operation,was not obviously recovered,1 died of colonic carcinoma.Conclusions The treatment of BCSDH was complicated by selection of drainage methods,the treatment of hematoma cavity and prevention of pneumatocephalus.There are different prognosis due to their different pathogeny in the patients with BCSDH.