硬质神经内镜治疗分隔型慢性硬膜下血肿的疗效
摘要
目的研究硬质神经内镜与常规钻孔引流术治疗分隔型慢性硬膜下血肿的临床疗效。方法回顾性分析太和县人民医院神经外科2015年1月至2017年9月收治的分隔型慢性硬膜下血肿患者的资料。内镜组(20例)采用硬质神经内镜辅助血肿清除术,对照组(25例)采用常规钻孔引流术,比较两组患者术后血肿清除率、中线移位、手术时间、引流管置入时间、住院时间及并发症(血肿复发、积气、积液、感染、癫痫和脑实质损伤)等。结果内镜组平均血肿清除率为95%,中线移位减小,住院时间与引流管放置时间缩短,均优于对照组(P <0. 05),但手术时间明显延长。两组患者癫痫和脑实质损伤发生率差异无统计学意义(P> 0. 05)。与内镜组比较,对照组患者血肿复发率、颅内积气积液以及感染发生率明显升高(P <0. 05)。结论硬质神经内镜辅助下治疗分隔型慢性硬膜下血肿,疗效较好。
引文
[1]BERHOUMA M,JACQUESSON T,JOUANNEAU E.The minimally invasive endoscopic management of septated chronic subdural hematomas:surgical technique[J].Acta Neurochirurgica,2014,156(12):2359-2362.
[2]杨振时,陈永翱,付为刚.慢性硬膜下血肿手术并发症防治探讨[J].安徽医学,2014,35(6):813-815.
[3]朱卿,王中勇,张檀,等.硬质神经内镜辅助手术治疗慢性硬膜下血肿的临床疗效[J].中国内镜杂志,2017,23(6):52-57.
[4]MASOPUST V,NETUKA D.Chronic subdural haematoma treatment with a rigid endoscope[J].Minim Invasive Neurosurg,2003,46(6):374-379.
[5]李亚平,张鉴文,范学政,等.硬质神经内镜治疗分隔型慢性硬膜下血肿[J].中国微侵袭神经外科杂志,2016,21(3):125-126.
[6]ILIESCU I A.Current diagnosis and treatment of chronic subdural haematomas[J].J Med Life,2015,8(3):278-284.
[7]褚闻来,王耿焕,褚正民,等.慢性硬膜下血肿术后脑组织复位对术后血肿复发的影响[J].中华全科医学,2018,16(9):1586-1590.
[8]KOLIAS A G,ASWIN C,THOMAS S,et al.Chronic subdural haematoma:modern management and emerging therapies.[J].Nat Rev Neurol,2014,10(10):570-578.
[9]HWAN K D,SOO K H,JIN C H,et al.Recurrence of the chronic subdural hematoma after burr-hole drainage with or without intraoperative saline irrigation.[J].Korean J Neurotrauma,2014,10(2):101-105.
[10]徐庚生,李美华,李义云.硬膜下积液是慢性硬膜下血肿形成的基础[J].江西医药,2010,45(2):114-116.
[11]AHN J H,JUN H S,KIM J H,et al.Analysis of risk factor for the development of chronic subdural hematoma in patients with traumatic subdural hygroma[J].J Korean Neurosurg Soc,2016,59(6):622-627.
[2]杨振时,陈永翱,付为刚.慢性硬膜下血肿手术并发症防治探讨[J].安徽医学,2014,35(6):813-815.
[3]朱卿,王中勇,张檀,等.硬质神经内镜辅助手术治疗慢性硬膜下血肿的临床疗效[J].中国内镜杂志,2017,23(6):52-57.
[4]MASOPUST V,NETUKA D.Chronic subdural haematoma treatment with a rigid endoscope[J].Minim Invasive Neurosurg,2003,46(6):374-379.
[5]李亚平,张鉴文,范学政,等.硬质神经内镜治疗分隔型慢性硬膜下血肿[J].中国微侵袭神经外科杂志,2016,21(3):125-126.
[6]ILIESCU I A.Current diagnosis and treatment of chronic subdural haematomas[J].J Med Life,2015,8(3):278-284.
[7]褚闻来,王耿焕,褚正民,等.慢性硬膜下血肿术后脑组织复位对术后血肿复发的影响[J].中华全科医学,2018,16(9):1586-1590.
[8]KOLIAS A G,ASWIN C,THOMAS S,et al.Chronic subdural haematoma:modern management and emerging therapies.[J].Nat Rev Neurol,2014,10(10):570-578.
[9]HWAN K D,SOO K H,JIN C H,et al.Recurrence of the chronic subdural hematoma after burr-hole drainage with or without intraoperative saline irrigation.[J].Korean J Neurotrauma,2014,10(2):101-105.
[10]徐庚生,李美华,李义云.硬膜下积液是慢性硬膜下血肿形成的基础[J].江西医药,2010,45(2):114-116.
[11]AHN J H,JUN H S,KIM J H,et al.Analysis of risk factor for the development of chronic subdural hematoma in patients with traumatic subdural hygroma[J].J Korean Neurosurg Soc,2016,59(6):622-627.