慢性硬膜下血肿的手术治疗

目的 总结慢性硬膜下血肿手术治疗的经验及疗效。方法 回顾性分析132例慢性硬膜下血肿患者的临床及神经影像学特征、手术方法和经验。结果 132例患者均采用钻孔冲洗引流术，其中6例患者改行开颅血肿清除术。124例治愈，5例复发，经原钻孔再次引流手术后治愈，2例因引流管移位进入脑组织致术后出现偏瘫或偏瘫加重，1例术后1月内死于其它疾病。结论 慢性硬膜下血肿的首选方法是钻孔引流术，对于包膜肥厚或血肿尚未完全液化者，宜采用骨瓣开颅手术治疗。

Surgical management of chronic subdural hematoma

Objective To report the experience of surgical treatment of chronic subdural hematoma (CSDH). Methods the clinical features, radiological findings,operative techniques and outcome of 132 patients with CSDH were analysis retrospectively. Results All the patients (132 ) were initially treated by burr hole craniotomy with closed system drainage , and 6 out of the 132 patients were reoperated by larger craniotomy. Of all the patients, 124(93.9%) were cured, 5(3.8%) had recurrence, 2(1.5%) got hemi paralysis, and 1(0.8%) died due to other disease. Conclusions Burr hole craniotomy with closed system drainage is effective for the initial treatment of CSDH. Craniotomy should be carried out only in patients with accumulating hematomas.