微创软通道血肿引流术治疗横窦骑跨性硬膜外血肿98例  

Minimally invasive soft-channel drainages Treatment of 98 cases Traumatic Epidural Hematoma Straddling Transverse Sinus

作　　者：陆兆丰[1] 程小兵[1] 张鸿日[1] 

机构地区：[1]河南科技大学第一附属医院神经外科,河南洛阳471000

出　　处：《湖北医药学院学报》2012年第3期213-215,219,共4页Journal of Hubei University of Medicine

摘　　要：目的:探讨横窦骑跨性硬膜外血肿的手术治疗效果。方法:98例创伤性横窦骑跨性硬膜外血肿患者分为开颅组(40例)与微创引流组(58例)。开颅组全麻下骨窗开颅血肿清除,微创引流组局麻CT定位下以软通道引流管穿刺血肿腔,并以尿激酶5～6万IU冲洗引流。比较两组不同时间点的血肿体积,并发症发生率以及3月后GOS评分。结果:微创引流组术后1 d CT显示血肿量较术前显著减少(P<0.05),3～5 d血肿完全清除。术后7 dGCS评分较术前显著提高(P<0.05)。两组并发症发生率及术后三月GOS评分差异均无统计学意义。结论:微创软通道血肿引流术对横窦骑跨性硬膜外血肿疗效显著,并有方便快捷,创伤小等优点。Objective To investigate the effect of criniotomy and minimally invasive drainage on epidural hematoma straddling transverse sinus.Methods Ninty-eight patients were randomly divided into two groups:criniotomy group(40 patients) and minimally invasive drainage(58 patients).The hematoma was evacuated under general anesthesia in criniotomy group.The soft-channel drainage tube was punctured into hematoma cavity under Local anesthesia using CT positioning,using 50~60 thousands of Urokinase Irrigation and drainage.We compared the hematoma volume,incidence of complications and 3 months post-treatment GOS.Results The hematoma volume significantly decreased in minimally invasive drainage at 1 days postsurgery(P<0.05) and total evacuation was performed at 3~5 days postsurgery in both groups.The Glasgow Coma Scale significantly increased in minimally invasive drainage and criniotomy group at 7 days postsurgery(P<0.05).GOS had no significant difference in criniotomy group and minimally invasive drainage group at 3 months follow-up(P>0.05).There was no significant difference in the complication incidence between criniotomy group and minimally invasive drainage group(P>0.05).Conclusion Minimally invasive soft-channel drainage is effective and more quicker,safer and has small influence on patients in the treatment of epidural hematoma straddling transverse sinus.

关 键 词：横窦骑跨性硬膜外血肿 微创软通道血肿引流术 手术治疗 GCS评分 

分 类 号：R651.15[医药卫生—外科学]