额顶部与顶部钻孔治疗慢性硬膜下血肿的疗效分析  

Comparison of frontoparietal drill versus parietal drill in burring hole and drainage for chronic subdural hematoma

作　　者：罗成军[1] 吴虹刚[1] 詹傲[1] 王山[1] 王庭刚[2] 

机构地区：[1]乐山市人民医院神经外科,四川乐山614000 [2]第三军医大学西南医院急救部,重庆400038

出　　处：《局解手术学杂志》2017年第9期679-681,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的比较分析额顶部与顶部钻孔引流治疗慢性硬膜下血肿的手术疗效,为临床治疗钻孔部位的选择提供依据。方法选取我院2013年1月至2016年1月收治的82例慢性硬膜下血肿患者,按患者入院日单双号随机分为观察组和对照组,观察组42例采取冠状位血肿最厚层面靠前1/4血肿长径处约额顶部为钻孔点,对照组40例采取冠状位血肿最厚层面约靠近顶结节处为钻孔点。比较2组患者术后残余血肿量、颅内积气量、复发率、神经功能和精神状态。结果观察组术后残余血肿量、颅内积气量、复发率、CSS明显低于对照组,2组比较差异具有统计学意义(P<0.05),观察组MMSE评分明显高于对照组,2组比较差异具有统计学意义(P<0.05)。结论额顶部钻孔较顶部钻孔治疗慢性硬膜下血肿,更有利于清除血肿,促进神经功能恢复。Objective To investigate the efficacy of frontoparietal drill versus parietal drill in the burring hole and drainage for chronic subdural hematoma（CSDH） ,and provide an evidence for clinical application. Methods A total of 82 patients with CSDH from January 2013 to January 2016 in our hospital were randomly divided into observation group and control group. The observation group chose frontoparietal drill which located at the front 1/4 point at the axial view with the thickest hematoma. Control group chose parietal drill which nearby the parietal tuberodties at the axial view with the thickest hematoma. The postoperative residual hematoma volume,intracranial gas volume, recurrence rate, neurologic function and mental state between two groups were compared. Results The postoperative residual hematoma volume, intracranial gas volume, the recurrence rate and CSS were lower compared with the control group, the differences were significant （ P 〈 0.05 ）. The MMSE score of observation group were higher that of the control group, the difference was significant （ P 〈 0.05 ）. Conclusion The frontopa- rietal drill has a better effect to remove the hematoma and promotes neural functional recovery.

关 键 词：硬膜下血肿 钻孔部位 神经功能 残余血肿量 复发率 

分 类 号：R615[医药卫生—外科学]