一种慢性硬膜下血肿改良手术方式与常规钻孔引流术的回顾性对比研究  

Retrospective Comparative Study of A Modified Surgical Approach under Chronic Subdural Hematoma and Routine Drilling and Drainage

作　　者：丁建 DING Jian(Neurosurgery Department,Qingpu Branch,Fudan University Affiliated Zhongshan Hospital,Shanghai 201700)

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

出　　处：《智慧健康》2023年第5期76-79,共4页Smart Healthcare

基　　金：上海市青浦区科技发展基金项目《主动骨孔内引流术治疗高龄老人慢性硬膜下血肿的疗效研究》(项目编号:QKY2019-11)。

摘　　要：目的 术后颅腔积气是手术常见并发症,目前没有相关手段可以显著避免。本研究改良了术式,拟与传统的钻孔引流术对比术后排气效果及相关预后。方法 回顾性研究2020年1月-2021年1月在复旦大学附属中山医院青浦分院神经外科进行手术治疗的慢性硬膜下血肿患者的临床资料,包括基本信息、既往史信息、手术方式、术后预后指标等。共79例需手术治疗的慢性硬膜下血肿患者被评估为合格。其中49例患者被随机分配入对照组,行常规钻孔引流术;30例患者被随机分配入试验组,进行改良术式。术后均进行6个月的随访。重点事件为术后血肿再次增多和CSDH复发。对比分析两组间并发症、疗效和预后情况。结果 试验组与对照组术后颅腔积气发生率对比(P<0.001)。试验组与对照组术后CSDH复发率对比(P=0.496)。试验组与对照组术后6个月ADL评分对比(P<0.05)。结论 改良手术方式降低了慢性硬膜下血肿术后颅腔积气的发生率,并在一定程度上改善了预后情况。Objective Postoperative pneumocephaly is common complication of surgery,and there is no relevant means to significantly avoid it currently.The study modified surgical procedure to compare postoperative exhaust effect and related prognosis with traditional drilling and drainage.Methods The paper reviewed and studied clinical data of chronic subdural hematoma patients with surgical treatment in Neurosurgery Department,Fudan University Zhongshan Hospital Qingpu Branch from January 2020 to January 2021,including basic information,past history information,surgical methods,and postoperative prognostic indicators.79 patients with chronic subdural hematoma with surgical treatment were evaluated as eligible.Among them,49 cases were randomly included in control group treated with routine drilling and drainage;30 cases in experiment group treated with improved surgical procedures.All patients were followed up for 6 months.Key events included increased hematoma and CSDH recurrence after surgery.Complications,effect,and prognosis between two groups was compared and analyzed.Results Incidence of postoperative pneumocephaly in experiment group and control group was compared(P<0.001).Comparison of postoperative recurrence rates of CSDH between experiment group and control group showed(P=0.496).Comparison of ADL scores between experiment group and control group 6 months after surgery showed(P<0.05).Conclusion Improved surgical method can reduce incidence of postoperative pneumocephaly of chronic subdural hematoma and improve prognosis to some extent.

关 键 词：慢性硬膜下血肿 钻孔引流术 血肿改良手术 回顾性对比研究 

分 类 号：R651.15[医药卫生—外科学]