硬通道硬膜下穿刺预减压联合开颅术治疗急性硬膜下血肿并脑疝的临床研究  

Clinical Study on hard-channel subdural puncture pre-decompression combined with craniotomy in the treatment of acute subdural hematoma complicated by brain hernia

作　　者：杜春生[1] 黄燕钦 吴彬冰 DU Chunsheng;HUANG Yanqin;WU Binbing(Department of Craniocerebral Surgery,Puning Overseas Chinese Hospital,Guangdong,Jieyang 515300,China)

机构地区：[1]普宁华侨医院颅脑外科,广东揭阳515300

出　　处：《中国医药科学》2023年第7期182-185,共4页China Medicine And Pharmacy

基　　金：广东省揭阳市科技计划项目(ylxm067)。

摘　　要：目的研究硬通道硬膜下穿刺预减压联合开颅术治疗急性硬膜下血肿并脑疝的临床效果。方法选取普宁华侨医院颅脑外科2020年6月至2022年6月收治的急性硬膜下血肿并脑疝患者40例,采用随机数表法分为对照组和观察组,每组各20例。对照组实施标准外伤大骨瓣开颅术治疗,观察组采取硬通道硬膜下穿刺预减压联合开颅术治疗。统计致残率、病死率、并发症发生率,采用生活质量评价量表(SF-36)对生存质量进行评定并对比以上数据差异。结果观察组的致残率为10.00%、病死率为5.00%、并发症发生率为10.00%,低于对照组的25.00%、15.00%、25.00%,差异有统计学意义(P<0.05);苏醒后两组患者的生存质量评分比较,差异无统计学意义(P>0.05),出院前均高于苏醒后,且观察组的生存质量评分高于对照组,差异有统计学意义(P<0.05)。结论硬通道硬膜下穿刺预减压联合开颅术治疗急性硬膜下血肿并脑疝疗效确切,能够进一步降低由该病症所带来的残疾、病死以及相关并发症发生风险,预后良好,在临床中具有广阔的推广使用前景和价值。Objective To study the clinical efficacy of hard-channel subdural puncture pre-decompression combined with craniotomy in the treatment of acute subdural hematoma complicated by brain hernia.Methods A total of 40 patients with acute subdural hematoma complicated by brain hernia admitted to the Department of Craniocerebral Surgery of Puning Overseas Chinese Hospital from June 2020 to June 2022 were selected,and they were grouped by the random number table method,with 20 patients in each group.The control group was treated with standard large trauma craniotomy,while the observation group was treated with hard-channel subdural puncture pre-decompression combined with craniotomy.The disability rate,mortality rate and complication rate were counted,the quality of life was assessed with the quality of life assessment scale(SF-36),and the above data differences were compared.Results The disability rate,mortality rate and complication rate of the observation group(10.00%,5.00%and 10.00%respectively)were lower than those of the control group(25.00%,15.00%and 25.00%respectively),and the differences were statistically significant(P<0.05).There was no statistically significant difference in the quality of life score between the two groups after awakening(P>0.05).The quality of life score just before discharge was higher than that after awakening,and the quality of life score in the observation group was higher than that in the control group,with statistically significant differences(P<0.05).Conclusion Hard-channel subdural puncture pre-decompression combined with craniotomy in the treatment of acute subdural hematoma complicated by brain hernia shows definite efficacy,and may further reduce the risk of disability,death and related complications caused by the disease and promote an ideal prognosis.Therefore,it has broad prospects and value for clin ical use in the future.

关 键 词：急性硬膜下血肿 脑疝 硬通道硬膜下穿刺预减压 开颅术 

分 类 号：R651.15[医药卫生—外科学]