慢性硬膜下血腫應(yīng)用微創(chuàng)鉆孔引流術(shù)的臨床效果

[摘要] 目的 探討分析慢性硬膜下血腫（CSDH）患者應(yīng)用微創(chuàng)鉆孔引流術(shù)的治療效果。方法 從2015年5月—2016年5月期間收治的慢性硬膜下血腫患者中，隨機選取68例患者作為實驗對象，按照入院順序，單號作為對照組（n=34），雙號作為觀察組（n=34），對照組患者給予傳統(tǒng)鉆孔引流術(shù)治療，觀察組患者采用微創(chuàng)鉆孔引流術(shù)治療，觀察兩組患者手術(shù)時間、血腫消失時間，并比較兩組臨床療效。 結(jié)果 觀察組患者血腫消失時間、手術(shù)時間均短于對照組（P<0.05）；觀察組患者治療有效率91.18%，高于對照組73.53%（P<0.05）；觀察組患者并發(fā)癥發(fā)生率5.88%，低于對照組14.71%，差異有統(tǒng)計學(xué)意義（P<0.05）。 結(jié)論 針對慢性硬膜下血腫患者，應(yīng)用微創(chuàng)鉆孔引流術(shù)治療，有利于縮短手術(shù)操作時間，并發(fā)癥少，加快血腫消失速度，有效減輕臨床癥狀，提高治療有效率，促進患者早期康復(fù)，值得進一步推廣應(yīng)用。

[關(guān)鍵詞] 慢性硬膜下血腫；微創(chuàng)鉆孔引流術(shù)；臨床效果

[中圖分類號] R651 [文獻標識碼] A [文章編號] 1674-0742（2016）12（b）-0088-03

Clinical Effect of Minimally Invasive Puncture Drainage for Chronic Subdural Hematoma

LIU Guo-sheng

Xiamen City Haicang Hospital， Neurosurgery Department， Xiamen，F(xiàn)ujian Province，361000 China

[Abstract] Objective To investigate the therapeutic effect of minimally invasive drilling drainage in patients with chronic subdural hematoma （CSDH）. Methods From patients treated during May 2015 to May 2016 the chronic subdural hematoma in 68 patients randomly selected as the experimental object， according to the order of admission， a single number as the control group （n=34）， even as the observation group （n=34）， patients in the control group was treated with traditional drilling drainage， the observation group were treated by minimally invasive trepanation and drainage. Observe two groups of patients with operation time， hematoma disappeared time and clinical efficacy were compared between two groups. Results The observation group patients with hematoma disappeared time and operation time were shorter than the control group（P<0.05）； the effective rate of the observation group was 91.18%， higher than 73.53% in the control group （P<0.05）； patients in the observation group the incidence of complications was 5.88%， 14.71% lower than the control group，the difference was statistically significant（P<0.05）. Conclusion For patients with chronic subdural hematoma were treated by minimally invasive drilling drainage， can shorten the operation time， less complications， accelerate the speed of hematoma disappeared， effectively relieve the clinical symptoms， improve the treatment efficiency， promote early rehabilitation of patients， is worthy of further promotion and Application.

[Key words] Chronic subdural hematoma； Minimally invasive drainage； Clinical effect

隨著社會各行業(yè)不斷發(fā)展，交通、建筑行業(yè)帶來的安全問題越來越多，直接威脅著人們的身心健康和生命安全。慢性硬膜下血腫（CSDH）是顱腦外傷后3周左右蛛網(wǎng)膜和硬腦膜形成的包膜血腫[1]，其發(fā)生機制目前尚未完全闡明。慢性硬膜下血腫臨床表現(xiàn)顱內(nèi)壓升高、精神障礙、失語、偏癱等，降低患者生活質(zhì)量。慢性硬膜下血腫發(fā)展為慢性過程，若能及時診斷和積極治療，對降低致殘率和致死率具有重要作用。手術(shù)是治療CSDH的常見方法，如鉆孔引流術(shù)、大骨瓣開顱血腫清除術(shù)、小骨瓣開窗剔除血腫囊壁術(shù)等。……