早期软通道技术在急性硬膜下血肿合并脑疝中的临床研究  

Earlier clinical research of soft-tube technology in acute subdural hematoma with hernia

作　　者：袁鹏[1] 方波[1] 黄涛[1] 刘科[1] 

机构地区：[1]重庆市急救医疗中心神经外科,400014

出　　处：《重庆医学》2012年第24期2493-2495,共3页Chongqing medicine

基　　金：重庆市医疗特色专科基金资助项目(2010-52)

摘　　要：目的探讨软通道技术在严重颅脑创伤中急性硬膜下血肿合并脑疝形成患者术前的应用价值。方法将2009年10月至2011年11月因重型颅脑损伤后急性硬膜下血肿合并脑疝行去骨瓣减压术的73例患者随机分为两组,软通道组33例在去骨瓣减压术前快速应用软通道技术引流血肿。对照组40例快速滴入甘露醇250mL后直接行去骨瓣减压术。两组患者血肿清除去骨瓣减压术方式及术后治疗方法相同。结果软通道引流能降低ICP,减少常规钻颅引流的并发症。比较两组术前散大瞳孔变化及术后GCS评分,软通道组更具有优势,差异有统计学意义(P<0.05)。结论软通道引流技术在急性硬膜下血肿合并脑疝术前能有效降低颅内压,为后期开颅手术赢得时间,并改善预后,值得临床推广。Objective To investigate the application of the soft-tube technology in acute subdural hematoma with hernia cases suffered from severe traumatic brain injury.Methods 73 cases of decompressive craniectomy in acute subdural hematoma with herniation followed severe head injury,from October 2009 to November 2011,were randomly divided into two groups.Soft-tube group of 33 cases：rapid soft-tube drainage of hematoma before decompressive craniectomy.Control group of 40 patients：decompressive craniectomy after rapid infusion of mannitol 250 mL.Removing of hematoma,decompressive craniectomy and postoperative treatment were in the same way.Results Both of ICP and the complications of conventional drilling drainage can be reduced in soft-tube drainage technology.By comparing the two groups of preoperative dilated pupil and postoperative GCS score,more advantages were in the group of soft-tube drainage,the difference was statistically significant（P〈0.05）.Conclusion Intracranial pressure can be reduced in the acute subdural hematoma with hernia by soft-tube drainage technology.More time of craniotomy is gained,the prognosis is improved.The methods is worthy of promotion.

关 键 词：软通道技术 急性硬膜下血肿 脑疝 

分 类 号：R651.1[医药卫生—外科学]