不同手术方式治疗进展型硬膜下积液的临床疗效和相关因素分析

发布时间：2018-02-22 04:23

  本文关键词： 硬膜下积液 手术方式 治疗结果 危险因素　出处：《重庆医学》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨不同手术方式治疗进展型硬膜下积液(TSE)的临床疗效及影响手术疗效的相关因素。方法选取2011年1月至2015年6月165例于遵化市第二医院行手术治疗的进展型TSE患者作为研究对象,其中70例行钻孔引流术(A组),57例行带蒂颞肌瓣填塞术(B组),38例行硬膜下腔-腹腔分流术(C组)。比较3组患者的临床疗效,并分析影响手术疗效的相关因素。结果 B组和C组的术后住院时间、治愈率和治疗有效率均高于于钻孔组,术后神经功能缺损评分均低于钻孔组,C组的术后住院时间亦高于B组,且差异均有统计学意义(均P0.05)。但3组的术后并发症发生率的差异无统计学意义(均P0.05)。手术治疗总体有效率为81.8%(135/165)。单因素分析结果显示手术疗效与年龄、积液量、手术方式、使用脱水剂有关(均P0.05)。多因素分析结果显示年龄≥60岁和积液量≥100mL是影响手术疗效的独立危险因素,行带蒂颞肌瓣填塞术、硬膜下腔-腹腔引流术和不使用脱水剂是影响手术疗效的保护性因素(均P0.05)。结论带蒂颞肌瓣填塞术和硬膜下腔-腹腔引流术治疗进展型TSE患者的手术疗效相当,均优于钻孔引流术,但均存在一定的手术无效率,尤其是对于年龄≥60岁、积液量≥100mL和使用脱水剂的患者。
[Abstract]:Objective to investigate the clinical efficacy of different surgical methods in the treatment of progressive subdural effusion (TSE) and the related factors affecting the surgical efficacy. Methods from January 2011 to June 2015, 165 patients with advanced subdural effusion were treated in Zunhua second Hospital. Type type TSE patients, 70 cases were treated with drilling and drainage, 57 cases with pedicle temporalis muscle flap tamponade and 38 cases with subdural cavities and peritoneal shunt in group B. The clinical efficacy of the three groups was compared. Results the postoperative hospitalization time, cure rate and effective rate in group B and C were higher than those in group B and group C. The postoperative neurological deficit score was lower in group C than that in group C, and the postoperative hospitalization time in group C was higher than that in group B. The difference was statistically significant (all P 0.05), but there was no significant difference in the incidence of postoperative complications among the three groups (all P 0.05). The total effective rate of operation was 81.8%, 135 / 165%. The results of univariate analysis showed that the effect of operation was related to age, volume of effusion, and operation mode, but there was no significant difference in the incidence of postoperative complications among the three groups (P < 0.05). The results of multivariate analysis showed that age 鈮，

本文编号：1523625