老年慢性硬膜下血肿的微创治疗

目的探讨微创手术治疗老年人慢性硬膜下血肿的疗效。方法对20例老年慢性硬膜下血肿患者采用微创手术清除颅内血肿、辅以促进受压脑组织复位等治疗措施。结果术前血肿量平均100ml，术后血肿清除或基本清除。受压脑组织复位时间24h～7d，平均3d，均痊愈出院。20例患者术后随访3～12月，平均7月，根据日常生活活动能力（ADL）分级法，正常16例，生活自理4例；CT随访16例，正常13例，脑萎缩2例，轻度局限性硬膜下积液1例。结论微创血肿清除术治疗老年人慢性硬膜下血肿疗效满意，复发率低。

Minimally invasive treatment for chronic subdural hematoma in the elderly patients

Objective To explore the curative efficacy of minimally invasive treatment for chronic subdural hematoma in elderly patients. Methods From February 2005 to February 2008, the clinical data of 20 elderly pa-tients suffered from chronic subdural hematoma were analyzed retrospectively. The patients were all treated by mini-mally invasive operations, along with the supportive treatment for repnsition of the brain. Results The hematomas (mean volume, 100 ml) were all cleared away postoperation. Brain reposition was obtained 24 hours ～ 7 days(mean, 3 days) after operations. All patients were cured to discharge. 20 patients were followed up for 3 ～ 12 months (mean,7 months). According to the activities of daily living (ADL) grading system, 16 patients were classified as normal, and 4 independent. Follow-up examination with CT scans in 16 patients showed 13 cases of normal findings, 2 cases of brain atrophy, and 1 mild subdural effusion. Conclusion Minimally invasive evacuation of hematoma is suited to elderly patients with chronic subdural hematoma,providing a satisfactory effect and a low recurrence rate.