慢性硬膜下血肿术后复发的原因探讨

目的探讨慢性硬膜下血肿(csDH)术后复发的原因。方法 8例复发者再次手术，切取的包膜留作病理切片，光镜下观察包膜组织的变化。结果 8例复发者经再次手术治疗，治愈7例，死亡1例。手术标本光镜下观察，发现包膜内血管增生伴大量嗜酸性粒细胞浸润。结论手术操作轻柔，避免颅内压急剧变化和血肿残留，保持引流通畅，是降低CSDH术后复发的有效措施。

Study of Causes of Postoperative Recurrence in chronic Subdural Hematoma

Objective To study the causes of postoperative recurrence in chronic subdural hematoma (CSDH). Methods Pieces of the resected capsule taken from 8 of 90 reoperatied cases were examinated under microscopy. Results 7 of 8 recurrenced cases were cured by reoperation, with one death. Proliferation of capillaries and invasion of huge amounts of eosinophil granulocytes in the intima if the capsule were observed in the surgical specimen under microscopy. Conclusion Meticulous manipulation, protection from abrupt change of intracranial pressure and prevention of residual blood clots in the capsule, patent drainage are the efficient ways to decreas the postoperative recurrence rate in CSDH.