改良钻孔引流术治疗对老年慢性硬膜下血肿患者临床疗效及近期预后的影响  

Effect of Modified Trepanation and Drainage on Clinical Efficacy and Short-term Prognosis of Elderly Patients with Chronic Subdural Hematoma

作　　者：丁建 盛罗平 张晟 徐福林 DING Jian;SHENG Luoping;ZHANG Sheng;XU Fulin(Department of Neurosurgery,Qingpu Branch of Zhongshan Hospital,Fudan University,Shanghai 201700,China;Department of Neurosurgery,Central Hospital of Minhang District,Shanghai 201199,China)

机构地区：[1]复旦大学附属中山医院青浦分院神经外科,上海201700 [2]上海市闵行区中心医院神经外科,上海201199

出　　处：《临床误诊误治》2023年第3期69-72,共4页Clinical Misdiagnosis & Mistherapy

基　　金：上海市卫生健康委员会项目(202040106)。

摘　　要：目的 分析改良钻孔引流术治疗对老年慢性硬膜下血肿患者临床疗效及近期预后的影响。方法 选择2019年6月—2021年6月收治慢性硬膜下血肿86例的资料进行回顾性分析,根据治疗方式将其分为对照组42例和观察组44例。对照组采用常规钻孔引流术治疗,观察组采用改良钻孔引流术治疗。观察2组手术时间、住院时间、术中出血量、临床疗效及并发症发生情况。经1个月随访后,记录2组术后发生残疾、复发情况以及脑组织复张情况。结果 观察组手术时间、住院时间均短于对照组(P<0.01);2组术中出血量比较差异无统计学意义(P>0.05)。观察组治疗总有效率、脑组织复张良好率明显高于对照组(P<0.05,P<0.01);观察组残疾率、复发率以及并发症总发生率明显低于对照组(P<0.05,P<0.01)。结论 改良钻孔引流术能缩短慢性硬膜下血肿患者手术时间与住院时间,可有效提高治疗效果和脑组织复张良好率,降低术后残疾率和复发率,具有较高的安全性。Objective To analyze the effect of modified trepanation and drainage on clinical efficacy and short-term prognosis of elderly patients with chronic subdural hematoma.Methods Clinical data of 86 patients with chronic subdural hematoma treated from June 2019 to June 2021 were retrospectively analyzed,and were divided into control group(n=42)and observation group(n=44)according to treatment methods.The control group was treated with conventional trepanation and drainage,and the observation group was treated with modified trepanation and drainage.The duration of operation,length of hospital stay,intraoperative blood loss,clinical efficacy and complications of the two groups were observed.After 1-month follow-up,the postoperative disability,recurrence and reexpansion of brain tissue were recorded in the two groups.Results The duration of operation and length of hospital stay of the observation group were shorter than those of the control group(P<0.01).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).The total effective rate and good reexpansion rate of brain tissue in the observation group were significantly higher than those in the control group(P<0.05,P<0.01).The disability rate,recurrence rate and total complication rate of the observation group were significantly lower than those of the control group(P<0.05,P<0.01).Conclusion Modified trepanation and drainage can shorten the duration of operation and length of hospital stay of chronic subdural hematoma,effectively improve the therapeutic effect and the excellent and good rate of brain tissue reexpansion,and reduce the rate of postoperative disability and recurrence,with high safety.

关 键 词：血肿 硬膜下 慢性 改良钻孔引流 复发 近期预后 并发症 

分 类 号：R651.155[医药卫生—外科学]