两种硬膜下引流方式治疗慢性硬膜下血肿的疗效分析  

Clinical analysis of two subdural drainage methods in the treatment of chronic subdural hematomas

作　　者：刘海巍 陶胜忠[2] LIU Haiwei;TAO Shengzhong(Department of Neurosurgery,the First People's Hospital of Zhumadian,Zhumadian,463000,China;Department of Neurosurgery,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou,450003,China)

机构地区：[1]驻马店市第一人民医院神经外科,河南驻马店463000 [2]郑州大学第二附属医院神经外科,河南郑州450003

出　　处：《中国实用神经疾病杂志》2019年第23期2629-2634,共6页Chinese Journal of Practical Nervous Diseases

基　　金：2018年河南省科技厅科技攻关资助项目(编号:182102310711)

摘　　要：目的比较颅骨钻孔T管引流术和常规硬膜下引流术治疗慢性硬膜下血肿(CSDH)的临床治疗效果,为临床手术方式的选择提供参考。方法回顾性分析2011-12-2018-12驻马店市第一人民医院神经外科收治的108例CSDH患者的临床资料,按引流方法分为T管引流组和常规硬膜下引流组,并对相关变量进行统计学分析。结果 2组手术时间、住院时间、术后3个月Markwalder神经功能分级方面无显著性差异(P>0.05)。T管引流组术后并发症发生率和血肿复发率均低于常规硬膜下引流组(P<0.05)。结论两种手术方法均取得了较好的治疗效果,但T管引流术总体术后并发症发生率和血肿复发率均低于常规硬膜下引术,表明颅骨钻孔T管引流术可能是治疗CSDH更好的手术选择。Objective To comparison the clinical effects of Burr-hole craniostomy with T-tube drainage andconventional subdural drainage in the treatment of(CSDH),and to provide reference for the selection of clinical surgical methods.Methods Clinical data of 108 cases of CSDH in the department of neurosurgery of The No.1 People’s Hospital of Zhumadian from December 2011 to December 2018 were analyzed retrospectively.According to the drainage method,the patients were divided into T tube drainage group and conventional subdural drainage group,and the related variables were statistically analyzed.Results There was no significant difference between the two groups in sex,age,preoperative Markwalder grade scale,preoperative hematoma volume,operation time,hospitalization days,and Markwalder grade scale of 6 months after operation(P>0.05).The incidence of postoperative complications and recurrence rate of hematomas in T tube drainage group were significantly lower than those in routine subdural drainage group(P<0.05).Conclusion Both methods have achieved good treatment,but the overall incidence of postoperative complications and the recurrence rate of hematomas after T-tube drainage are lower than those in the conventional subdural drainage group.This suggests thatburr-hole craniostomy with T-tube drainagemay be a better choice for the treatment of CSDH.

关 键 词：慢性硬膜下血肿 颅骨钻孔 T管引流术 常规硬膜下引流术 术后并发症 血肿复发 

分 类 号：R651.1+5[医药卫生—外科学]