开颅术后并发硬膜下积液的临床分型及治疗策略探讨

目的：探讨开颅术后并发硬膜下积液的临床分型及治疗策略。方法：对150例资料较完整的开颅术后硬膜下积液患者，根据其动态CT观察转归进行分型，分别为消退型、稳定型、进展型和演变型，并对其，临床特点进行总结、分析。结果：开颅术后并发硬膜下积液34例，占开颅术后患者总数的22．67％，稳定型4例占11．7％，消退型24例占70．6％，进展型6例占17．6％。动态头颅CT观察未进展且消退24例；稳定型4例，1例开颅手术行颅骨修补而治愈；进展型皮下穿刺吸引加压包扎1例，蛛网下腔置管引流2例，积液腹腔分流3例；演变型0例。结论：对开颅并发硬膜下积液患者，应采取动态观察CT、蛛网膜下腔置管外引流、皮下穿刺外引流、积液腹腔分流等治疗方法。

Postoperative craniotomy subdural effusion Classification and treatment strategies

Objective：To investigate craniotomy subdural effusion complicated the clinical classification and treatment strategies. Methods 150 patients with complete data craniotomy subdural effusion, observed outcome under the dynamic CT were classified, respectively, regression-based, stable, progressive and evolving type, and the clinical characteristics summary and analysis. Results Postoperative craniotomy subdural effusion 34 cases, accounting for the total number of patients after craniotomy 22.67%, stable in 4 cases accounted for by 11.7%, regression model accounted for 24 cases, 70.6% progressive, 17.6% in 6 cases. Dynamic cranial CT did not observe the progress and regression 24; stable in 4 cases, 1 case of craniotomy lines cured cranioplasty; progressive skin puncture to attract bandaged one case of the spider＇s web inferior vena tube drainage in 2 cases, peritoneal fluid shunt in 3 cases; the evolution of type 0. Conclusion Concurrent craniotomy subdural effusion, should take the dynamic observation ofCT, subarachnoid catheter drainage, the skin puncture drainage, effusion peritoneal shunt treatment.