单孔钻颅冲洗并外引流术治疗慢性硬膜下血肿的价值
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摘要
目的分析单孔钻颅冲洗联合外引流术治疗慢性硬膜下血肿的价值。方法回顾性分析2015年4月—2018年7月在该院神经外科接受治疗的56例慢性硬膜下血肿患者,都接受单孔钻颅冲洗并外引流术治疗。观察临床症状改善情况、脑部CT复查结果以及预后情况。结果 56例患者头晕、头痛、肢体乏力3种疾病发生症状均在术后1～2 d内消失,术后7～10 d,其他疾病症状都有好转。在拔管之前接受脑部CT检查发现,所有患者硬膜下血肿明显清除消失或转变为少量积液残留,脑组织受压较前缓解,脑中线复位良好。56例患者术后均无颅内感染、新发出血及癫痫发作等情况,随访1～6个月,其中有41例患者在该院门诊复诊,15例患者经过电话随访,复查脑部CT均未发现血肿复发的情况,无伤口感染、颅内感染及癫痫发作的情况。结论慢性硬膜下血肿采取单孔钻颅冲洗并外引流术治疗效果比较理想,应用价值比较高。
Objective To analyze the value of single-hole drilling and external drainage in the treatment of chronic subdural hematoma. Methods A retrospective analysis of 56 patients with chronic subdural hematoma who underwent neurosurgery in our hospital from April 2015 to July 2018 underwent single-hole drilling and external drainage. Observe the improvement of clinical symptoms, CT findings of the brain and prognosis. Results The symptoms of dizziness,headache and limb weakness in 56 patients disappeared within one to two days after surgery. Seven to ten days after surgery, the symptoms of other diseases improved. Before the extubation, CT examination of the brain showed that the subdural hematoma disappeared or disappeared into a small amount of effusion residue in all patients. The brain tissue was relieved under pressure and the midline of the brain was well restored. There were no intracranial infections, new blood and seizures in 56 patients. All patients were followed up for 1-6 months. Among them, 41 patients were reviewed in our outpatient clinic, and 15 patients were followed up by telephone. No recurrence of hematoma was found, and no wound infection, intracranial infection, or seizure occurred. Conclusion The treatment of chronic subdural hematoma with single-hole drilling and external drainage is ideal and the application value is relatively high.
Objective To analyze the value of single-hole drilling and external drainage in the treatment of chronic subdural hematoma. Methods A retrospective analysis of 56 patients with chronic subdural hematoma who underwent neurosurgery in our hospital from April 2015 to July 2018 underwent single-hole drilling and external drainage. Observe the improvement of clinical symptoms, CT findings of the brain and prognosis. Results The symptoms of dizziness,headache and limb weakness in 56 patients disappeared within one to two days after surgery. Seven to ten days after surgery, the symptoms of other diseases improved. Before the extubation, CT examination of the brain showed that the subdural hematoma disappeared or disappeared into a small amount of effusion residue in all patients. The brain tissue was relieved under pressure and the midline of the brain was well restored. There were no intracranial infections, new blood and seizures in 56 patients. All patients were followed up for 1-6 months. Among them, 41 patients were reviewed in our outpatient clinic, and 15 patients were followed up by telephone. No recurrence of hematoma was found, and no wound infection, intracranial infection, or seizure occurred. Conclusion The treatment of chronic subdural hematoma with single-hole drilling and external drainage is ideal and the application value is relatively high.
引文
[1]陈新,张传玲,王伟功.锥颅引流术与钻孔冲洗引流术治疗慢性硬膜下血肿的疗效对比分析[J].中国临床神经外科杂志,2016,21(1):53-55.
[2]别小华,冯清亮,薛俊刚,等.锥颅与钻孔置管冲洗引流术治疗慢性硬膜下血肿的疗效对比[J].蚌埠医学院学报,2015,40(12):1651-1654.
[3]左治强,姜红田,张伟,等.颅骨钻单孔冲洗引流治疗慢性硬膜下血肿疗效分析[J].现代医药卫生,2016,32(20):3200-3201.
[4]Kameda,Katsuharu,Shono,Tadahisa,Takagishi,Soh et al.Epst ein-Barr virus-positive diffuse large B-cell primary central nervous system lymphoma associated with organized chronic subdural hematoma:A case report and review of the literature[J].Pathology International,2015,65(3):138-143.
[5]徐博.颅骨钻孔联合不同引流术治疗慢性硬膜下血肿的临床疗效观察[J].国际医药卫生导报,2015,21(23):3448-3449.
[6]王志威,韩杰林,李耀军,等.改良钻孔引流术治疗慢性硬膜下血肿的临床观察[J].中国药物与临床,2015,26(7):1016-1018.
[7]王斌,杨秀莹.高位颅骨钻孔置管冲洗引流术治疗慢性硬膜下血肿[J].临床外科杂志,2016,24(1):58-59.
[8]Tempaku,Akira,Yamauchi,Shigeru,Ikeda,Hidetoshi et al.Usefulness of interventional embolization of the middle meningeal artery for recurrent chronic subdural hematoma:Five cases and a review of the literature[J].Interventional neuroradiology:journal of peritherapeutic neuroradiology,surgical procedures and related neurosciences,2015,21(3):366-371.
[9]刘晓斌,赵晓君,李民,等.改良单孔引流术治疗老年慢性硬膜下血肿的疗效观察[J].临床医学研究与实践,2017,2(3):50-51.
[10]赵印生,衣服新,鲍龙.慢性硬膜下血肿钻孔引流术术中冲洗、不冲洗的临床疗效比较[J].锦州医科大学学报,2017,38(3):18-20.
[11]何海波,贾根来,丁兵,等.用单孔颅骨钻孔微创手术治疗慢性硬膜下血肿的效果探究[J].当代医药论丛,2017,15(12):34-35.
[12]郑伏根.颅骨钻孔引流治疗慢性硬膜下血肿应用效果观察及评估[J].医学理论与实践,2016,29(19):3338-3340.
[13]Busl,Katharina M.,Ouyang,Bichun,Boland,Torrey A.et al.Prolonged Mechanical Ventilation is Associated With Pulmonary Complications,Increased Length of Stay,and Unfavorable Discharge Destination Among Patients With Subdural Hematoma[J].Journal of neurosurgical anesthesi ology,2015,27(1):31-36.
[14]滕景情.颅内血肿粉碎穿刺针与颅骨钻孔血肿引流术治疗慢性硬膜下血肿的临床比较[J].深圳中西医结合杂志,2017,27(6):15-16.
[15]潘星志.在CT定位下使用颅骨钻孔引流术治疗亚急性硬膜下血肿的效果分析[J].当代医药论丛,2016,14(13):13-15.
[16]曾德兵,陈飞,王小龙,等.单孔钻颅冲洗并外引流术治疗慢性硬膜下血肿31例临床分析[J].安徽医学,2010,31(4):360-361.
[2]别小华,冯清亮,薛俊刚,等.锥颅与钻孔置管冲洗引流术治疗慢性硬膜下血肿的疗效对比[J].蚌埠医学院学报,2015,40(12):1651-1654.
[3]左治强,姜红田,张伟,等.颅骨钻单孔冲洗引流治疗慢性硬膜下血肿疗效分析[J].现代医药卫生,2016,32(20):3200-3201.
[4]Kameda,Katsuharu,Shono,Tadahisa,Takagishi,Soh et al.Epst ein-Barr virus-positive diffuse large B-cell primary central nervous system lymphoma associated with organized chronic subdural hematoma:A case report and review of the literature[J].Pathology International,2015,65(3):138-143.
[5]徐博.颅骨钻孔联合不同引流术治疗慢性硬膜下血肿的临床疗效观察[J].国际医药卫生导报,2015,21(23):3448-3449.
[6]王志威,韩杰林,李耀军,等.改良钻孔引流术治疗慢性硬膜下血肿的临床观察[J].中国药物与临床,2015,26(7):1016-1018.
[7]王斌,杨秀莹.高位颅骨钻孔置管冲洗引流术治疗慢性硬膜下血肿[J].临床外科杂志,2016,24(1):58-59.
[8]Tempaku,Akira,Yamauchi,Shigeru,Ikeda,Hidetoshi et al.Usefulness of interventional embolization of the middle meningeal artery for recurrent chronic subdural hematoma:Five cases and a review of the literature[J].Interventional neuroradiology:journal of peritherapeutic neuroradiology,surgical procedures and related neurosciences,2015,21(3):366-371.
[9]刘晓斌,赵晓君,李民,等.改良单孔引流术治疗老年慢性硬膜下血肿的疗效观察[J].临床医学研究与实践,2017,2(3):50-51.
[10]赵印生,衣服新,鲍龙.慢性硬膜下血肿钻孔引流术术中冲洗、不冲洗的临床疗效比较[J].锦州医科大学学报,2017,38(3):18-20.
[11]何海波,贾根来,丁兵,等.用单孔颅骨钻孔微创手术治疗慢性硬膜下血肿的效果探究[J].当代医药论丛,2017,15(12):34-35.
[12]郑伏根.颅骨钻孔引流治疗慢性硬膜下血肿应用效果观察及评估[J].医学理论与实践,2016,29(19):3338-3340.
[13]Busl,Katharina M.,Ouyang,Bichun,Boland,Torrey A.et al.Prolonged Mechanical Ventilation is Associated With Pulmonary Complications,Increased Length of Stay,and Unfavorable Discharge Destination Among Patients With Subdural Hematoma[J].Journal of neurosurgical anesthesi ology,2015,27(1):31-36.
[14]滕景情.颅内血肿粉碎穿刺针与颅骨钻孔血肿引流术治疗慢性硬膜下血肿的临床比较[J].深圳中西医结合杂志,2017,27(6):15-16.
[15]潘星志.在CT定位下使用颅骨钻孔引流术治疗亚急性硬膜下血肿的效果分析[J].当代医药论丛,2016,14(13):13-15.
[16]曾德兵,陈飞,王小龙,等.单孔钻颅冲洗并外引流术治疗慢性硬膜下血肿31例临床分析[J].安徽医学,2010,31(4):360-361.