硬通道微创穿刺治疗慢性硬膜下血肿的临床效果
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摘要
目的探讨硬通道微创穿刺治疗慢性硬膜下血肿的临床效果。方法选取2017年6～12月我院收治的80例慢性硬膜下血肿患者作为研究对象,按照随机数字表法将其分为观察组和对照组,每组各40例。观察组患者采用硬通道微创穿刺治疗,对照组患者采用钻孔引流治疗。比较两组患者的手术时间、术后引流时间、住院时间、并发症发生和复发情况以及治疗效果。结果观察组患者的手术时间、术后引流时间和住院时间均短于对照组,并发症发生率和复发率均低于对照组,差异有统计学意义(P<0.05)。观察组患者的治愈率略高于对照组,但差异无统计学意义(P>0.05);两组患者的治疗总有效率比较,差异无统计学意义(P>0.05)。结论硬通道微创穿刺治疗慢性硬膜下血肿的效果与传统钻孔引流术相当,但是硬通道微创穿刺治疗可明显缩短手术时间、术后引流时间、住院时间,且术后并发症和复发率明显降低。
Objective To investigate the clinical effect of hard channel minimally invasive puncture in the treatment of chronic subdural hematoma. Methods A total of 80 cases of chronic subdural hematoma patients treated in our hospital from June to December 2017 were selected as study objects. All the patients were divided into the observation group and the control group according to the random number table method, with 40 cases in each group. The observation group was treated with hard channel minimally invasive puncture, and the control group was treated with drilled drainage. The operation time, postoperative drainage time, hospitalization time, complications, recurrence, and treatment effect were compared between the two groups. Results The operation time, postoperative drainage time and hospitalization time in the observation group were shorter than those in the control group, the complication rate and recurrence rate in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). The cure rate of the observation group was slightly higher than that of the control group, but the difference was not statistically significant(P>0.05), and there was no significant difference in the total effective rate of treatment between the two groups(P >0.05). Conclusion The effect of hard channel minimally invasive puncture in the treatment of chronic subdural hematoma is equal to that of traditional drilled drainage, but hard channel minimally invasive puncture can significantly shorten the time of operation, postoperative drainage time and hospitalization time,and reduce the postoperative complications and recurrence rate.
Objective To investigate the clinical effect of hard channel minimally invasive puncture in the treatment of chronic subdural hematoma. Methods A total of 80 cases of chronic subdural hematoma patients treated in our hospital from June to December 2017 were selected as study objects. All the patients were divided into the observation group and the control group according to the random number table method, with 40 cases in each group. The observation group was treated with hard channel minimally invasive puncture, and the control group was treated with drilled drainage. The operation time, postoperative drainage time, hospitalization time, complications, recurrence, and treatment effect were compared between the two groups. Results The operation time, postoperative drainage time and hospitalization time in the observation group were shorter than those in the control group, the complication rate and recurrence rate in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). The cure rate of the observation group was slightly higher than that of the control group, but the difference was not statistically significant(P>0.05), and there was no significant difference in the total effective rate of treatment between the two groups(P >0.05). Conclusion The effect of hard channel minimally invasive puncture in the treatment of chronic subdural hematoma is equal to that of traditional drilled drainage, but hard channel minimally invasive puncture can significantly shorten the time of operation, postoperative drainage time and hospitalization time,and reduce the postoperative complications and recurrence rate.
引文
[1]黄冠又,张欣,明悦,等.影响慢性硬膜下血肿钻孔引流术后复发的因素分析[J].国际神经病学神经外科学杂志,2016,43(2):124-127.
[2]殷义明,罗成.慢性硬膜下血肿术后复发的危险因素分析[J].第二军医大学学报,2013,34(6):687-689.
[3]牙昌权.慢性硬膜下血肿颅骨钻孔血肿引流术后并发症防治探讨[J].河北医学,2014,20(1):77-79.
[4]吴烁龙.YL-1型碎吸针治疗老年人慢性硬膜下血肿的疗效观察[J].中国实用医药,2014,9(10):46-47.
[5]任东坡.慢性硬膜下血肿液中VEGF、D-二聚体的测定及意义[J].临床神经外科杂志,2011,8(4):195-196.
[6]华杰,傅小君,许信龙,等.VEGF、纤维蛋白原及D-二聚体在慢性硬膜下血肿中的作用及临床意义[J].浙江创伤外科,2012,17(4):433-435.
[7]刘恒军.硬通道微创穿刺术在脑出血患者中的应用价值[J].中国药物经济学,2017,12(3):147-149.
[8]彭中,代凌,熊文中.硬通道微创穿刺清除术治疗高血压脑出血的临床观察[J].中国医药导刊,2012,14(2):735-736.
[9]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.
[10]黄冠又,张欣,明悦,等.影响慢性硬膜下血肿钻孔引流术后复发的因素分析[J].国际神经病学神经外科学杂志,2016,43(2):124-127.
[11]寇欣.改良与传统钻孔引流术治疗慢性硬膜下血肿的疗效比较[J].神经损伤与功能重建,2016,11(5):465-466.
[12]王莹莹,张泰铭,赵宪林.微创穿刺术与钻孔引流术治疗慢性硬膜下血肿疗效Meta分析[J].山西医药杂志,2016,45(9):1056-1060.
[13]罗铸.硬通道微创穿刺引流术对高血压脑出血患者治疗效果颅内感染率及穿刺出血率的影响[J].河北医学,2017,23(2):312-314.
[14]陈冬云,李宝东.硬通道微创穿刺术治疗急性稳定型硬膜外血肿[J].实用医药杂志,2016,33(8):684-686.
[15]王广山.硬通道微创穿刺引流术治疗高血压脑出血对血肿清除率及神经功能改善的影响[J].中国实用医药,2017,12(24):48-49.
[16]李奎智,雷国亮,张成贵.微创穿刺引流联合开颅减压治疗高血压脑出血突发脑疝的疗效分析及其对脑部血流和预后的影响[J].中国医药导报,2018,15(14):50-53.
[2]殷义明,罗成.慢性硬膜下血肿术后复发的危险因素分析[J].第二军医大学学报,2013,34(6):687-689.
[3]牙昌权.慢性硬膜下血肿颅骨钻孔血肿引流术后并发症防治探讨[J].河北医学,2014,20(1):77-79.
[4]吴烁龙.YL-1型碎吸针治疗老年人慢性硬膜下血肿的疗效观察[J].中国实用医药,2014,9(10):46-47.
[5]任东坡.慢性硬膜下血肿液中VEGF、D-二聚体的测定及意义[J].临床神经外科杂志,2011,8(4):195-196.
[6]华杰,傅小君,许信龙,等.VEGF、纤维蛋白原及D-二聚体在慢性硬膜下血肿中的作用及临床意义[J].浙江创伤外科,2012,17(4):433-435.
[7]刘恒军.硬通道微创穿刺术在脑出血患者中的应用价值[J].中国药物经济学,2017,12(3):147-149.
[8]彭中,代凌,熊文中.硬通道微创穿刺清除术治疗高血压脑出血的临床观察[J].中国医药导刊,2012,14(2):735-736.
[9]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.
[10]黄冠又,张欣,明悦,等.影响慢性硬膜下血肿钻孔引流术后复发的因素分析[J].国际神经病学神经外科学杂志,2016,43(2):124-127.
[11]寇欣.改良与传统钻孔引流术治疗慢性硬膜下血肿的疗效比较[J].神经损伤与功能重建,2016,11(5):465-466.
[12]王莹莹,张泰铭,赵宪林.微创穿刺术与钻孔引流术治疗慢性硬膜下血肿疗效Meta分析[J].山西医药杂志,2016,45(9):1056-1060.
[13]罗铸.硬通道微创穿刺引流术对高血压脑出血患者治疗效果颅内感染率及穿刺出血率的影响[J].河北医学,2017,23(2):312-314.
[14]陈冬云,李宝东.硬通道微创穿刺术治疗急性稳定型硬膜外血肿[J].实用医药杂志,2016,33(8):684-686.
[15]王广山.硬通道微创穿刺引流术治疗高血压脑出血对血肿清除率及神经功能改善的影响[J].中国实用医药,2017,12(24):48-49.
[16]李奎智,雷国亮,张成贵.微创穿刺引流联合开颅减压治疗高血压脑出血突发脑疝的疗效分析及其对脑部血流和预后的影响[J].中国医药导报,2018,15(14):50-53.