钻孔后双腔管冲洗引流治疗双侧慢性硬脑膜下血肿

目的：探讨双腔管冲洗引流术（double-cavity cannula irrigation and drainage,DCCID）在双侧慢性硬脑膜下血肿（bilateral chronic subduralhem atoma,BCSDH）治疗中的作用及方法。方法：19例BCSDH在仰卧、头偏、一次手术准备条件下完成双侧钻孔冲洗并双腔管置入。术后通过双腔管置换出颅内积气;对未全液化及术后急性硬脑膜下血肿,通过注入尿激酶进行溶解、冲洗、引流。结果：所有患者术后病情即获改善,18例患者通过冲洗置换出颅内积气,5例未全液化或术后急性硬脑膜下血肿通过注入尿激酶溶解避免了开颅或再次钻孔引流。未发生张力性气颅、感染、癫痫等并发症,术后随访3个月未发现血肿复发。结论：DCCID使BCSDH手术简单、安全、有效、手术并发症及血肿复发发生率低,且使未全液化血肿及术后硬脑膜下出血者避免了开颅或再次钻孔引流术。

Clinical Investigation of Double-Cavity Cannula Irrigation and Drainage for Treatment of Bilateral Chronic Subdural Hematoma

Objective：To explore the methods and efficacy of double-cavity cannula irrigation and drainage （DCCID）on the treatment of bilateral chronic subdural hematoma （BCSDH）. Methods： ：19 cases BCSDH received bilateral burr halo and placement of double-cavity eannula（DCC） in supine position. After operation, the intracranial gas were exchanged by irrigation fluid and outmoded/fleshed blood clots were dissolved by urokinase , then excluded in some cases. Results：The intracranial gas were exchanged and excluded in 18 patients, in 5 patients outmoded or freshed blood clots were dissolved and excluded. No complications such as Tension pneumocephalus,intracranial infection ,epilepsy and recurrence of CSDH were founded in the 3 months follow up duration. Conclusion：DCCID can make the treatment of BCSDH simple, safe, effective, with low complication rate, besides this, it can avoid craniotomy or secondary operation in the patients with subdural outmoded or freshed blood clots.