慢性硬膜下血肿术后复发诊治分析  

Analysis of Causes and Treatment of Postoperative Recurrence in Chronic Subdural Hematoma

作　　者：刘红林[1] 丁丙谦[1] 陈小兵[1] 周玉璞[1] 段国庆[1] 

机构地区：[1]河南大学淮河医院神经外科,开封市475000

出　　处：《医药论坛杂志》2006年第15期24-25,共2页Journal of Medical Forum

摘　　要：目的探讨慢性硬膜下血肿(CSDH)术后复发的原因及其治疗方法。方法12例复发者再次手术,切取的包膜作病理切片,光镜下观察包膜组织的变化。结果11例复发者经再次手术治疗治愈,1例在一周内再次复发,经第三次手术治愈。手术标本光镜下观察发现包膜内血管增生伴大量嗜酸性粒细胞浸润。结论手术操作轻柔,避免颅内压急剧变化和血肿残留,保持引流通畅,是降低CSDH术后复发的有效措施。慢性硬膜下血肿复发的首选治疗方法是钻孔引流术。Objective To analyse the causes chronic subdural hematoma（CSDH）. Methods Pieces and treatment of postoperative recurrence in of the resected capsule taken from 12 of 147 reoperated cases were examinated under microscopy. Results 1 lof 12 recurrenced cases were cured by reoperation,with one recurrenced secondly. Proliferation of capillaries and invasion of huge amounts of eosinophil granulocytes in the intima if the capsule were observed in the surgical specimen under microscopy. Conclusion Meticulous manipulation,protection from abrupt change of intracrantial pressure and prevention of residual blood clots in the capsule, patent drainage are the efficient ways to decrease the postoperative recurrence rate in CSDH. Burr hole craniotomy with closed - system drainage is effective for the initial treatment of postoperative recurrence in CSDH.

关 键 词：慢性硬膜下血肿 手术 复发 

分 类 号：R651.15[医药卫生—外科学]