不同温度冲洗液治疗慢性硬膜下血肿的疗效观察  

Observation on effect of different temperatures of flushing fluid for treating chronic subdural hematoma

作　　者：谢源 程远[1] 黄琴[1] XIE Yuan;CHENG Yuan;HUANG Qin(Department of Neurosurgery,Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院神经外科,400010

出　　处：《重庆医学》2020年第9期1387-1390,共4页Chongqing medicine

基　　金：国家自然科学基金项目(81771861,81401505)。

摘　　要：目的探讨不同温度冲洗液治疗慢性硬膜下血肿(CSDH)的临床疗效,为CSDH术中冲洗液温度的选择提供依据。方法本研究为前瞻性研究,根据随机数字表将2016年3月至2018年6月入住该院的90例CSDH患者分为观察组和对照组,每组45例。两组均行YL-1型硬通道钻孔引流术,观察组给予低温(10℃)冲洗液予以交换冲洗,对照组给予手术室室温(20~23℃)下冲洗液交换冲洗,比较两组患者的并发症发生率、早期脑复张程度、血肿复发率等。结果观察组患者术后第7天脑组织与硬膜之间的间隙为(2.38±0.81)cm,对照组患者为(2.85±1.26)cm,观察组早期脑复张明显优于对照组,两组比较差异有统计学意义(P<0.05);术后随访3个月观察组患者复发率为2.22%,对照组为13.33%,两组患者复发率比较差异有统计学意义(P<0.05);两组患者术后头痛、急性颅内血肿、颅内积气发生率比较,差异均无统计学意义(P>0.05)。结论CSDH患者YL-1型穿刺针硬通道钻孔引流术,术中使用低温冲洗液具有早期脑复张率好且复发率低的优点。Objective To explore the clinical efficacies of different temperatures of flushing fluid in the treatment of chronic subdural hematoma(CSDH)to provide a basis for the selection of flushing fluid temperature in the treatment method of CSDH.Methods This study was a prospective study.According to the random number table,90 patients with CSDH in this hospital during March 2016 to June 2018 were divided into the observation group and control group,with 45 cases in each group.The YL-1 type hard-channel drilling drainage was performed in both groups.The observation group was given the hypothermia(10℃)flushing fluid for conducting the exchange flushing,while the control group was given the flushing fluid for conducting the exchange flushing under the operating room temperature(about 20-23℃).The incidence rate of complications,degree of early brain reexpansion and hematoma recurrence rate were compared between the two groups.Results The gap between the brain tissue and dura on postoperative 7 d in the observation group was(2.38±0.81)cm,which in the control group was(2.85±1.26)cm,the early brain reexpansion in the observation group was significantly better than that in the control group,and the difference between the two groups was statistically significant(P<0.05).The recurrence rate in postoperative 3 months in the observation group was 2.22%,which in the control group was 13.33%,the difference between the two groups was statistically significant.(P<0.05);there was no statistically significant difference in the incidence rates of postoperative headache,acute intracranial hematoma and intracranial pneumatosis between the two groups(P>0.05).Conclusion Using hypothermia flushing fluid in the Y1-type puncture needle hard channel drilling drainage has the advantages of good brain reexpansion rate and low recurrence rate.

关 键 词：血肿 硬膜下 慢性 低温 前瞻性研究 硬通道微创穿刺 

分 类 号：R743[医药卫生—神经病学与精神病学]