慢性硬膜下血肿钻孔外引流术后张力性气颅9例临床分析  

Trepanation and drainage of chronic subdural hematoma complicating tension pneumothorax in 9 cases

作　　者：李深誉[1] 孙卫东[1] 黎景光[1] 罗益民[1] 李邱旺 杨琨[1] 龙任 

机构地区：[1]娄底市中心医院神经外科,娄底市417000

出　　处：《立体定向和功能性神经外科杂志》2013年第3期176-179,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨慢性硬膜下血肿钻孔引流术后张力性气颅的临床表现、发生机制与治疗方法。方法选取本院收治的慢性硬膜下血肿钻孔引流术后张力性气颅患者9例,其中7例患者行锥颅排气再手术并置硅胶管持续引流,2例单纯通过调整引流管排气。结果术后7天后,患者头颅CT检查结果示气体大部分排除,仅1例残余少量积液存于薄层硬膜下,中线结构无偏移,脑组织受压得到缓解。所有病例均于10天～1个月后痊愈出院。出院后随访,无1例出现血肿复发或遗留血肿。结论锥颅排气再手术并双引流管接闭式引流术或经调整引流管排气是治疗慢性硬膜下血肿钻孔引流术后张力性气颅有效方法。术后常规行颅内压监护及头颅CT复查对于慢性硬膜下血肿钻孔外流术后张力性气颅的及时诊断与治疗有重要意义。Objective To explore the diagnosis,pathogenesis,treatment and prevention of chronic subdural hematoma complicating with tension pneumothorax.Methods 9cases of chronic subdural hematoma complicating tension pneumothorax were selected as the research objective,in which 2patients adjusted the drainage pipe exhaust,the rest of the cases were performed emergency burr hole drainage.Results The pneumatosis of the patients was almost absorbed within 7 days after treatment of intracranial hematoma,only 1cases with residual small amount of effusion in the subdural thin.After 3 months of follow-up,nobody was recurred.Conclusion Double drainage tube after closed drainage or adjusted drainage pipe exhaust was an effective method for tension pneumocephalus trepanation.Routine monitoring of postoperative intracranial pressure and timely examination of CT can be helpful for the diagnosis and surgical treatment.

关 键 词：慢性硬膜下血肿 钻孔引流 张力性气颅 

分 类 号：R651.1[医药卫生—外科学]