改良内镜手术治疗慢性硬脑膜下血肿的疗效

目的 评估改良内镜(MES)手术技术,在气环境下清除慢性硬脑膜下血肿(CSDH)的疗效.方法 65例CSDH患者,采用MES手术治疗27例(A组),钻孔冲洗术38例(B组),术后3d内复查头颅CT,随访3个月～1年,比较两组疗效.结果 A组术后3 d内中线移位完全回复率为92.6%,高于B组的71.1%(P<0.05).B组血肿复发率为23.7%;A组无复发病例.B组中第1次治疗失败4例,其中3例改行开颅血肿清除及包膜切除术治愈;9例复发后再次钻孔冲洗治愈.结论 与钻孔冲洗术比较,MES技术操作简便、微创、视野清晰、血肿清除满意、疗效佳.

Therapeutic effectiveness of modified endoscopic procedure in removal of chronic subdural hematoma

Objective To evaluate the efficiency of modified endoscopic(MES)operation in removal of chronic subdural hernatoma(CSDH)in air environment.Methods For the removal of CSDH,MES operation was performed in 27 patients(group A)and burrhole drainage technique in 27 cases(group B).The outcomes were evaluated by CT scanning within 3 days after operation and followed-up for 3 months to 1 year.Results Compared with burrhole drainage group,the percentage of complete restoration of midline shift was higher in group A than that in group B(92.6% vs.71.1%)(P＜0.05).There was no recurrence case in group A.The recurrence rate of group B was 23.7%.In group B,the first burrhole treatment failed in 4 cases,of whom 3 cases received craniotomy.The second burrhole drainage was performed in 9 cases with subdural hernatoma recurrence in group B.Conclusion Compared with burrhole drainage,MES technique has the advantages of convenience,minimal invasion,clear image,satisfactory hematoma removal and better theraputic results in removal of CSDH.