不同部位单孔钻孔冲洗引流术治疗慢性硬膜下血肿的临床疗效比较  

Comparison of clinical efficacy in treatment of chronic subdural hematoma with single hole drilling and drainage at different sites

作　　者：李长栋 蔡志标 周杰 王凯 LI Changdong;CAI Zhibiao;ZHOU Jie;WANG Kai(The 940th Hospital of Joint Logistic Support Force of PLA, Lanzhou 730050,China)

机构地区：[1]解放军联勤保障部队第940医院,甘肃兰州730050

出　　处：《西北国防医学杂志》2020年第9期549-552,共4页Medical Journal of National Defending Forces in Northwest China

基　　金：甘肃省青年科技基金计划(18JR3RA411)。

摘　　要：目的:比较耳尖前、耳尖上、耳尖后单孔钻孔冲洗引流术治疗慢性硬膜下血肿的临床疗效。方法:选取2016-02~2019-10我院神经内科收治的慢性硬膜下血肿患者60例为研究对象,随机分为耳尖前组、耳尖上组和耳尖后组,每组20例,均采用单孔钻孔冲洗引流术治疗。比较3组围术期的临床指标,包括切口长度、术中出血量、麻醉方式、手术时间、是否使用抗生素、住院时间、并发症发生率及治疗总有效率。结果:3组切口长度、术中出血量、麻醉方式、手术时间、住院时间比较,差异均无统计学意义(P>0.05);耳尖前组的治疗总有效率为95.0%,与耳尖上组的80.0%、耳尖后组的65.0%比较,差异有统计学意义(P<0.05);耳尖前组术后并发症发生率为0,明显低于耳尖上组的15.0%和耳尖后组的35.0%,差异有统计学意义(P<0.05)。结论:耳尖前钻孔冲洗引流术治疗慢性硬膜下血肿治疗总有效率高,术后并发症发生率低,更值得临床应用。Objective:To compare the clinical efficacy of single hole drilling and drainage before the ear tip,on the ear tip and behind the ear tip in treatment of chronic subdural hematoma(CSDH).Methods:Sixty patients with CSDH admitted to the department of neurosurgery in our hospital from February 2016 to October 2019 were selected and randomly divided into before the ear tip group,on the ear tip group and behind the ear tip group,20 cases in each group,three groups were treated with single hole drilling and drainage.The clinical parameters of the three groups were compared included incision length,intraoperative blood loss,anesthesia method,operation time,antibiotic use,hospitalization time,complications and total effective rate of treatment.Results:There were no significant differences in the incision length,intraoperative blood loss,anesthesia method,operation time and hospitalization time among the three groups(P>0.05).The total effective rate of treatment in the before the ear tip group was 95.0%,which were higher than that in on the ear tip group(80.0%)and behind the ear tip group(65.0%),the difference were statistically significant(P<0.05).The postoperative complications rate of before the ear tip group was 0,which were significantly lower than that of on the ear tip group(15.0%)and behind the ear tip group(35.0%),the difference were statistically significant(P<0.05).Conclusion:The single hole drilling and drainage at before the ear tip has the advantages of low incidence of postoperative complications and high effective rate,which is more worthy of clinical application.

关 键 词：慢性硬膜下血肿 不同部位 单孔钻孔冲洗引流术 临床疗效 

分 类 号：R743[医药卫生—神经病学与精神病学]