慢性硬膜下血肿两种钻孔引流术式比较

目的:钻孔手术是治疗慢性硬膜下血肿(chronic subdural hematoma,CSDH)最常见的治疗方式,通过比较钻单孔和钻双孔两种不同手术方式的效果,指导临床实践。方法:收集2012年1月至2013年12月在南充市中心医院接受钻孔冲洗加密闭引流手术治疗的152例CSDH患者的资料,统计两种钻孔方式治疗患者各自的手术时间、拔管时间、住院天数、气颅发生率、复发率等指标。结果:78例钻单孔的患者中,复发6例(7.69%);74例钻双孔的患者中,复发5例(6.76%),P>0.05。单、双孔手术各自的手术时间分别为(26.31±3.12)min、(53.20±4.58)min,P<0.01;术后拔管时间分别为(3.21±1.02)d、(2.90±1.53)d,P>0.05;住院天数分别为(5.02±1.25)d、(7.21±2.17)d,P<0.05;两者气颅发生各为18例(23.1%)、39例(52.70%),P<0.05。结论:钻单、双孔引流治疗CSDH的复发率较低,在减少手术时间、住院天数、气颅发生率方面,钻单孔具有优势。

Comparison of single burr hole drainage and double burr hole drainage for chronic subdural hematoma

Objective：To compare the effects of single burr hole and double burr hole drainage to guide clinical practice, as the burr hole craniotomy is the most frequently used neurosurgical treatment of chronic snbdural hematoma（CSDH）. Methods： A total of 152 cases who underwent burr hole eraniotomy with irrigation plus closed system drainage surgery were included. The data come from Nanchong Central Hospital during January 2011 and December 2013. The operation time, the extubation time, the length of stay in hospi- tal, number of pneumocephalus and the recurrence cases were statistically analyzed. Results： There were 6 cases （ out of 78 ） and 5 cases （ out of 74） experienced recurrences in the single burr hole group and double burr hole drainage group （ P 〉 0.05 ）. The operation time is（ 26.31 ± 3.12 ） minutes, （ 53.20 ± 4.58 ） minutes respectively （ P 〈 0.01 ）. The extubation time is （ 3.21 ± 1.02 ） days, （ 2.90 ± 1.53 ） days respectively （ P 〉 0.05 ）. The length of stay in hospital is （ 5.02 ± 1.25 ） days, （ 7.21 ± 2.17 ） days respectively （ P 〈 0.05 ）. There were 18 cases （ out of 78 ） and 39 cases （ out of 74） have pneumocephalus in each group （ P 〈 0.05 ）. Conclusion ： The single burr hole drainage and double burr hole drainage both have a lower recurrence rate in treating the CSDH. The single burr hole drainage surgery have superiority in shortening the time of operation and staying in hospital. It can also reduce the probability of pneumocephalus comparing with the contrast group.