手锥锥颅、CO_2气体置换治疗慢性硬膜下血肿  

Carbon dioxide gas replacement of chronic subdural hematoma with single micro-burr-hole tapping.

作　　者：高力[1] 邓靖[1] 林栋梁[1] 

机构地区：[1]自贡市第四人民医院神经外科,自贡643000

出　　处：《中国微创外科杂志》2001年第6期345-346,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨手锥单孔锥颅冲洗、CO2 气体置换慢性硬膜下血肿 (Chronicsubduralhematoma ,CSDH)的手术疗效。　方法　使用微创手锥单孔锥颅 ,经双腔导管冲洗引流、注入CO2 气体置换血肿 ,不放置引流管治疗 41例慢性硬膜下血肿。　结果　 41例CO2 气体术后 2 4小时吸收 ,症状体征消失 ,1例 2周后再出血复发。随访 1月至 2年 ,无颅内感染、张力性气颅、继发性颅内血肿、癫痫等并发症。　结论　微创手锥锥颅、CO2 气体置换CSDH是一种手术简便、创伤小、不置引流管、血肿腔可迅速闭合、复发率低的有效手术方法。Objective To study the effect of carbon dioxide gas replacement of chronic subdural hematoma treatment using single micro-burr-hole irrigation. Methods By single micro-burr-hole via percutaneous subdural hematoma cavity tapping, a double lumen tube was inserted into the hematoma cavity and irrigation of the hematoma with normal saline was conducted. Carbon dioxide gas was delivered to the hematoma cavity until the entire volume of the hematoma cavity was replaced with carbon dioxide gas, Then, the double lumen tube was drawn from the cavity Results 41 patients were treated with this method. All the patients were asymptomatic postoperatively. 24-hour postoperative CT scan presented with complete absorption of the carbon dioxide gas. 1 months to 2 years follow-up showed all the patients got uneventful recovery without inflammation and rebleeding, except for one recurrence (2.4%). Conclusions Carbon dioxide gas replacement of chronic subdural hematoma by single micro-burr-hole irrigation is a simple and minimally invasive procedure, which can obtain rapid reduction of the hematoam cavity without drainage and the rate of recurrence is very law.

关 键 词：慢性硬膜下血肿 二氧化碳 气体置换 微创外科 手锥 

分 类 号：R651.15[医药卫生—外科学]