经皮穿刺引流术治疗开颅去骨瓣减压术后硬膜下积液的疗效分析

目的探讨经皮穿刺引流术治疗开颅去骨瓣减压术后硬膜下积液的疗效分析。 方法选择爱德堡医院神经外科自2008年8月至2018年5月收治的60例开颅去骨瓣减压术后硬膜下积液患者为研究对象。根据患者病情及其家属意愿将采用经皮穿刺引流术治疗的患者设为观察组（30例），采用腰椎穿刺引流术治疗的患者设为对照组（30例），比较2组患者的治疗总有效率、治愈时间以及并发症的发生情况。 结果同对照组治疗总有效率（70.00%）比较，观察组的治疗总有效率（96.67%）获得明显提升（P<0.05）。对照组治愈时间为（12.69±2.13）d，观察组治愈时间为（7.78±1.24）d，观察组明显短于对照组（t=8.912，P=0.000）。2组患者术后均未发生颅内积气及感染，对照组出现穿刺点脑脊液漏3例，观察组出现头皮切口漏液2例，对症处理后均消失,差异无统计学意义（P>0.05）。 结论开颅去骨瓣减压术后硬膜下积液患者选择经皮穿刺引流术治疗，可以获得明显减压效果。

Treatment of percutaneous drainage for subdural effusion after decompressive craniectomy

ObjectiveTo explore the efficacy of percutaneous drainage in the treatment of subdural effusion after decompressive craniectomy. MethodsSixty patients with subdural effusion after decompression craniotomy in our hospital from August 2008 to May 2018 were selected as experimental subjects. According to the wishes of patients and their families, the patients treated by percutaneous drainage were set as observation group (30 cases), and the patients treated by lumbar puncture drainage were set as control group (30 cases). The total effective rate, healing time and complications of the two groups were compared. ResultsCompared with the control group, the total effective rate was significantly increased in the observation group (70.00% vs. 96.67%, P<0.05). The healing time of the observation group was shorter than that of the control group (7.78±1.24) d vs. (12.69±2.13) d], the difference was statistically significant (t=8.912, P=0.000). No intracranial gas accumulation or infection occurred in both 2 groups. There were 3 cases of cerebrospinal fluid leakage at the puncture site in the control group and 2 cases of scalp incision leakage in the observation group, all of which disappeared after the treatment of the disease, and the difference was not statistically significant (P>0.05). ConclusionSubdural effusion after decompression with craniotomy and osteotomy can be significantly reduced by percutaneous drainage.