微创穿刺引流与钻孔引流治疗慢性硬膜下血肿的疗效观察

目的比较微创穿刺引流与传统钻孔引流治疗慢性硬膜下血肿的临床疗效.方法分析10 a来昆明医学院第二附属医院神经外科采用微创穿刺引流术97例、钻孔引流术131例治疗慢性硬膜下血肿的临床资料,对两组术后残余液量、颅内积气等进行比较.结果单针微创穿刺术后残余液量、颅内积气小于单孔钻孔治疗;双针微创穿刺术后残余液量、颅内积气及引流时间小于双孔钻孔治疗;微创穿刺术后14 d病情改善优于钻孔引流,差异均有统计学意义（P〈0.05）.结论微创穿刺引流治疗优于传统钻孔引流治疗,具有创伤轻微、简便快捷、安全可靠、疗效确切、适应症广等优点,可作为临床治疗慢性硬膜下血肿的首选方法,值得临床推广应用.

Therapeutic Effects of Microinvasive Puncture Drainage and Trepanation and Drainage on Chronic Subdural Hematoma

Objective To compare the therapeutic effects of microinvasive puncture drainage and trepanation and drainage on chronic subdural hematoma.Methods We analyzed the clinic data of 97 cases of chronic subdural hematoma treated by microinvasive puncture drainage,and 131 cases of chronic subdural hematoma treated by trepanation and drainage in recent ten years in our hospital.Then we compared the difference in residual fluid content and intracranial gas of patients between the two treatment methods.Results The residual fluid content and intracranial gas after operation of patients treated by single-needle microinvasive puncture drainage was less than patients treated by single-hole trepanation and drainage.The double-needle microinvasive puncture drainage was better than double-hole trepanation and drainage in residual fluid content,intracranial gas,and drainage time after operation.The patients treated by microinvasive puncture drainage got better improvement on 14 day after operation than patients treated by trepanation and drainage,and the difference had statistical significance（P0.05）.Conclusions Microinvasive puncture drainage is better than trepanation and drainage in the treatment of chronic subdural hematoma.Microinvasive puncture drainage is microinvasive,simple,safe,effective,and has extensive indications,therefore it can be as the first choice for treatment of chronic subdural hematoma,and deserve to be generalized in clinic.