硬通道穿刺引流术联合脑膜中动脉栓塞治疗合并高危复发因素的慢性硬膜下血肿  

Safety and effectiveness of hard channel puncture and drainage combined with middle meningeal artery embolization for chronic subdural hematomas with high-risk recurrence factors

作　　者：钱尧轩 庄敏杰 周志杰 彭玮 闫西刚[1] QIAN Yao-xuan;ZHUANG Min-jie;ZHOU Zhi-jie;PENG Wei;YAN Xi-gang(Department of Neurosurgery,The People's Hospital of Wuzhong,Suzhou 215128,China)

机构地区：[1]苏州市吴中人民医院神经外科,江苏215128

出　　处：《中国临床神经外科杂志》2024年第11期655-659,664,共6页Chinese Journal of Clinical Neurosurgery

摘　　要：目的 探讨硬通道穿刺引流术联合脑膜中动脉(MMA)栓塞治疗含高危复发因素的慢性硬膜下血肿(CSDH)的安全性及有效性。方法 回顾性分析2021年1月至2023年4月手术治疗的22例含高危复发因素的CSDH的临床资料。所有病人均采用硬通道穿刺引流术联合MMA栓塞治疗。结果 栓塞方法:单纯EVAL胶栓塞13例,单纯弹簧圈栓塞2例,EVAL胶联合弹簧圈栓塞7例;双侧栓塞9例。术后CT复查显示血肿腔内密度增高9例。所有病人术后临床症状均缓解。22例术后随访3个月未见血肿进展、复发。结论 硬通道穿刺引流术联合MMA栓塞是治疗CSDH的有效手段之一,远期疗效有待进一步观察。Objective To investigate the safety and efficacy of hard-channel puncture and drainage combined with middle meningeal artery(MMA)embolization for chronic subdural hematomas(CSDHs)with high-risk recurrence factors.Methods The clinical data of 22 patients with CSDHs associated with high-risk recurrence factors who underwent hard-channel puncture and drainage combined with MMA embolization from January 2021 to April 2023 were retrospectively analyzed.Results Regarding the embolization methods,13 patients received pure EVAL glue embolization,2 received pure coil embolization,and 7 received a combination of EVAL glue and coil embolization;among them,9 patients underwent bilateral embolization.Postoperative CT reexamination indicated that the density within the hematoma cavity increased in 9 patients.All patients'clinical symptoms were alleviated after the operation.No hematoma progression or recurrence was observed during the 3-month follow-up.Conclusion Hard-channel puncture and drainage combined with MMA embolization is one of the effective approaches for treating CSDH associated with high-risk recurrence factors,but its long-term therapeutic effect still requires further observation.

关 键 词：慢性硬膜下血肿 脑膜中动脉栓塞 硬通道穿刺引流术 安全性 有效性 

分 类 号：R651.15[医药卫生—外科学] R651.11[医药卫生—临床医学]