两种术式治疗慢性硬膜下血肿的临床分析

发布时间：2018-10-13 11:42

【摘要】：目的:通过对66例慢性硬膜下血肿CSDH(chronic subdural hematoma)患者的一般资料进行分析,同时分别行单纯钻孔冲洗引流术与开颅血肿清除术两种术式,比较分析出二者的优缺点,继而总结出治疗CSDH最为合理、有效、经济的治疗方法。方法:对我院2014年9月到2017年1月延大附院神经外科收住的慢性硬膜下血肿的66例住院患者的一般资料进行回顾性分析,通过观察其年龄、血肿量、切口长度、出血量、手术用时、住院总费用、住院总时间、治愈率及并发症的发生率等因素,进行统计学研究分析,比较得出合适慢性硬膜下血肿最佳手术治疗方式。结果:66例患者均可以顺利完成手术。术后两组患者均能在复查完CT检查后,顺利拔除引流管,手术切口愈合均良好。对年龄、血肿量及治愈率三个因素分析出,单纯钻孔冲洗引流组与开颅血肿清除组,统计学分析表明,这两组之间的差异无明显统计学意义(P0.05);但在手术时间、住院总时间、术中总出血量、住院总费用、并发症等方面,单纯钻孔引流术组明显优于开颅组,统计学分析后,二者具有明显统计学差异(P0.05);两组在有无并发症之间也有明显统计学差异(P0.05),而在并发症方面,两组间继发性脑损伤这个因素的差异性较明显(P0.05)。结论:对此66例CSDH患者的一般资料总结分析,通过单纯钻孔冲洗引流术和开颅血肿切除术这两种手术治疗方法比较,我们发现,在所有因素内,年龄、血肿量、治愈率方面,两组无明显差异;但在手术切口长度、出血量、手术用时、住院总费用、住院时间等方面,单纯钻孔冲洗引流组明显优于开颅血肿清除组;并发症方面,开颅组明显多于钻孔引流冲洗组,其中继发性脑损伤这一因素较为突出。
[Abstract]:Objective: to analyze the general data of 66 patients with chronic subdural hematoma (CSDH (chronic subdural hematoma). Then summed up the most reasonable, effective and economical treatment of CSDH. Methods: the general data of 66 patients with chronic subdural hematoma admitted by neurosurgery from September 2014 to January 2017 were analyzed retrospectively. The age, hematoma volume, incision length and bleeding volume were observed. The factors such as the total cost of operation, total hospitalization time, cure rate and incidence of complications were analyzed statistically, and the optimal surgical treatment for chronic subdural hematoma was obtained. Results: all 66 patients were able to complete the operation successfully. After CT examination, the drainage tube was removed smoothly and the incision healed well. Three factors, age, hematoma quantity and cure rate, were analyzed. The statistical analysis showed that there was no significant difference between the two groups (P0.05), but in the operation time, the total length of hospitalization, the total time of operation, the difference between the two groups was not significant (P0.05). The total intraoperative bleeding, total hospital expenses, complications and other aspects were significantly better in the simple drilling and drainage group than in the craniotomy group. There was significant statistical difference between the two groups (P0.05); there was also a significant difference between the two groups in the complications (P0.05), but in the complications, the difference of the secondary brain injury between the two groups was significant (P0.05). Conclusion: the general data of 66 patients with CSDH were summarized and analyzed. By comparing the two surgical methods of simple drilling, irrigation and drainage and craniotomy, we found that, in all factors, age, hematoma volume, cure rate, and so on. There was no significant difference between the two groups, but the length of incision, the amount of bleeding, the total cost of hospitalization, the length of hospitalization, and the length of stay in the two groups were significantly better than those in the group of craniotomy and hematoma removal. Craniotomy group was more than drilling drainage group, and secondary brain injury was more prominent.
【学位授予单位】：延安大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.1

【参考文献】