硬通道钻孔引流治疗慢性硬膜下血肿的临床研究  

A Clinical Research of Drainage of Hard Channel Drilling in the Treatment of Chronic Subdural Hematoma

作　　者：陈加龙 林少弟 黄勇 

机构地区：[1]广东省揭阳市蓝城区人民医院,广东揭阳522000

出　　处：《中国医学创新》2015年第25期32-34,共3页Medical Innovation of China

摘　　要：目的:探讨金属硬通道钻孔引流术在慢性硬膜下血肿(chronic subdural hematoma,CSDH)治疗上的疗效和优点。方法:将58例慢性硬膜下血肿患者随机数字表法分为两组,A组29例采用经头皮切口颅骨钻孔硅胶管置入软通道引流治疗,B组29例采用金属硬通道经皮直接锥颅建立硬通道引流。统计对比两组病例的手术时间、拔管时间、麻醉要求、疗效、复发率、平均住院时间、气颅发生率、感染率等指标。结果:两组患者手术时间、住院时间、气颅发生率、麻醉要求比较,差异均有统计学意义(P<0.05);而术后拔管时间、复发率、感染率、显效率比较,差异无统计学意义。结论:采用金属硬通道直接锥颅建立硬通道引流治疗CSDH,在手术时间、住院时间、气颅发生率、麻醉要求上明显优于经头皮切口颅骨钻孔硅胶管置入软通道引流治疗CSDH;在感染率、复发率和拔管时间上比较无明显统计学差异,且疗效显著,操作方便,是治疗CSDH最简单、安全、有效的治疗方式,值得临床推广。Objective： To investigate the effect and advantages of metal hard channel invasive drilling in the treatment of chronic subdural hematoma （ CSDH ） . Method： 58 patients who had chronic subdural hematoma were divided into two groups randomly. Group A ： 29 cases underwent incision of scalp skull drilling silicone tube implantation of soft channel drainage treatment. Group B ： 29 cases used the metal hard channel to drill skull to build the drainage of hard channel though scalp. Operation time, extubation time, anesthetic requirement, curative effect, the recurrence rate, average hospitalization time, the incidence of intracranial pneumatosis, infection rate, and other indicators between the two grpups l^ere compared. Result： Operation time, hospitalization time, incidence of intracranial pneumatosis, anesthetic requirements between the two groups was compared and showed significantly different （ P〈0.05 ）, but extubation time after surgery, recurrence rate, infection rate, explicit efficiency did not show different. Conclusion： Using the metal hard channel to drill skull to build the drainage of hard channel to cure the CSDH that is better than using the method of incision of scalp skull drilling silicone tube implantation of soft channel drainage treatment in operation time, hospitalization time, the incidence of intracranial pneumatosis, anesthetic requirements. There is no statistically significant difference in the infection rate, recurrence rate and extubation time. Thus, curative effect of metal hard channel invasive drilling is remarkable, the operation is convenient, it is the most simple, safe and effective treatment for CSDH, and worth clinical promotion.

关 键 词：硬通道 软通道 钻孔引流 慢性硬膜下血肿 高速电钻 老年人 

分 类 号：R651.15[医药卫生—外科学]