本文選題：慢性硬膜下血腫 + 鉆孔沖洗引流術(shù)�。� 參考：《蚌埠醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討慢性硬膜下血腫(Chronic subdural haematoma,CSDH)鉆孔引流術(shù)后顱內(nèi)積氣對(duì)預(yù)后的影響。方法:1.對(duì)140例行鉆單孔沖洗引流術(shù)的慢性硬膜下血腫患者進(jìn)行前瞻性研究,使用Onis2.3.5 Image proplus軟件測(cè)量患者術(shù)前血腫量及術(shù)后第1天和術(shù)后4-10天時(shí)顱內(nèi)的血腫殘留量,運(yùn)用計(jì)算機(jī)輔助設(shè)計(jì)(Any CAD Viewer 5.0.)和計(jì)算機(jī)輔助制造(Any CAM Viewer 5.0.)軟件分別計(jì)算術(shù)后第1天、術(shù)后4-10天、術(shù)后1月的顱內(nèi)積氣量。記錄患者術(shù)前的GCS評(píng)分、血腫部位、有無外傷史等,記錄患者出院時(shí)GCS評(píng)分、3個(gè)月后隨訪的GOS評(píng)分、是否感染或復(fù)發(fā)等。2.將患者術(shù)前顱內(nèi)血腫量,分別與術(shù)后第1天頭顱CT顱內(nèi)積氣量和血腫殘留量進(jìn)行pearson直線相關(guān)分析;將患者術(shù)后第1天頭顱CT顱內(nèi)積氣量,分別與術(shù)后第1天顱內(nèi)血腫殘留量、出院時(shí)GCS評(píng)分、3個(gè)月后隨訪的GOS評(píng)分進(jìn)行pearson直線相關(guān)分析;將患者術(shù)后4-10天時(shí)顱內(nèi)積氣量與術(shù)后3個(gè)月的GOS評(píng)分進(jìn)行pearson直線相關(guān)分析。術(shù)后第1天、術(shù)后4-10天、術(shù)后1月左右時(shí)顱腦CT所示的顱內(nèi)積氣量之間差異進(jìn)行單因素方差分析。結(jié)果:140例慢性硬膜下血腫患者術(shù)前顱內(nèi)血腫量為114.66±25.10ml,臨床癥狀結(jié)合影像學(xué)資料分析均行硬膜下鉆單孔沖洗引流術(shù)�；颊咝g(shù)后第1天顱內(nèi)積氣量為28.63±26.96ml,顱內(nèi)血腫殘留量為13.11±11.27ml;出院時(shí)GCS評(píng)分為14.74±1.05,術(shù)后3個(gè)月GOS評(píng)分為4.79±0.53。pearson相關(guān)性統(tǒng)計(jì)分析發(fā)現(xiàn)患者術(shù)后第1天頭顱CT顱內(nèi)積氣量與患者術(shù)前顱內(nèi)血腫量呈正相關(guān)(P0.05);患者術(shù)后第1天頭顱CT顱內(nèi)血腫殘留量與患者術(shù)前顱內(nèi)血腫量具有正相關(guān)(P0.05);患者術(shù)后第1天頭顱CT顱內(nèi)積氣量與患者出院時(shí)GCS評(píng)分之間無統(tǒng)計(jì)學(xué)相關(guān)性(P0.05),患者出院時(shí)GCS評(píng)分與患者術(shù)后第1天頭顱CT顱內(nèi)血腫殘留量之間具有正相關(guān)(P0.05);患者術(shù)后3個(gè)月GOS評(píng)分與患者術(shù)后第1天頭顱CT顱內(nèi)積氣量之間無統(tǒng)計(jì)學(xué)相關(guān)性(P0.05);患者術(shù)后3個(gè)月GOS評(píng)分與患者術(shù)后4-10天時(shí)頭顱CT顱內(nèi)積氣量之間無統(tǒng)計(jì)學(xué)相關(guān)性(P0.05)。術(shù)后第1天、術(shù)后4-10天、術(shù)后1月左右時(shí)顱內(nèi)積氣量之間差異具有顯著統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:慢性硬膜下血腫鉆孔沖洗引流術(shù)后一定范圍內(nèi)的積氣量對(duì)患者預(yù)后無明顯影響。
[Abstract]:Objective: to investigate the effect of intracranial gas accumulation on the prognosis of chronic subdural hematoma (Chronic subdural haematoma subdural). Method 1: 1. A prospective study was carried out on 140 patients with chronic subdural hematoma who underwent single hole drilling irrigation and drainage. The preoperative hematoma volume was measured by Onis2.3.5 Image proplus software, and the residual intracranial hematoma was measured on the first day after operation and 4-10 days after operation. Any CAD Viewer 5.0) Any CAM Viewer 5.0) Intracranial air accumulations were calculated on the first day, 4-10 days and 1 month after operation. The preoperative GCS score, hematoma location, history of trauma, GCS score at discharge, GOS score after 3 months follow-up, infection or recurrence were recorded. The preoperative intracranial hematoma volume was analyzed by pearson linear correlation analysis with the intracranial air accumulation and hematoma residue on the first day after operation, and the intracranial hematoma volume on the first day after operation was compared with the intracranial hematoma residue on the first day after operation. The GCS score at discharge and the GOS score at 3 months follow-up were analyzed by pearson linear correlation analysis and pearson linear correlation analysis was performed between the intracranial air accumulation at 4-10 days after operation and the GOS score at 3 months after operation. Univariate analysis of variance (ANOVA) was performed on the first day, 4-10 days and 1 month after operation. Results the volume of intracranial hematoma was 114.66 鹵25.10 ml in 140 patients with chronic subdural hematoma before operation. On the first day after operation, the volume of intracranial gas accumulation was 28.63 鹵26.96 ml, the residual amount of intracranial hematoma was 13.11 鹵11.27 ml, the GCS score at discharge was 14.74 鹵1.05, and the GOS score at 3 months after operation was 4.79 鹵0.53.pearson. There was a positive correlation between the amount of intracranial hematoma and the amount of intracranial hematoma before operation on the first day after operation, and there was no correlation between the volume of intracranial hematoma on the first day after operation and the GCS score of the patient at the first day after operation, and there was a positive correlation between the amount of intracranial hematoma and the amount of intracranial hematoma on the first day after operation. There was a positive correlation between the GCS score at discharge and the residual amount of intracranial hematoma on the first day after operation (P 0.05), but there was no correlation between the GOS score at 3 months after operation and the intracranial air accumulation on the first day after operation. There was no significant correlation between the GOS score 3 months after operation and the intracranial volume of air accumulation on cranial CT at 4-10 days after operation (P 0.05). There were significant differences in intracranial air accumulation on the first day, 4-10 days and 1 month after operation (P 0.05). Conclusion: there is no significant effect on the prognosis of patients with chronic subdural hematoma.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R651.15

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 仲曉軍;楊欣剛;;同步鉆孔引流治療雙側(cè)慢性硬膜下血腫[J];中國(guó)微侵襲神經(jīng)外科雜志;2016年05期

2 李亞平;張鑒文;范學(xué)政;黃進(jìn)能;;硬質(zhì)神經(jīng)內(nèi)鏡治療分隔型慢性硬膜下血腫[J];中國(guó)微侵襲神經(jīng)外科雜志;2016年03期

3 李峰;;外傷性硬膜下積液演變?yōu)槁杂材は卵[臨床特點(diǎn)分析[J];中外醫(yī)學(xué)研究;2014年25期

4 劉向陽;錢忠心;趙鴻;龔良;丁勇;孫偉;劉衛(wèi)東;;神經(jīng)內(nèi)窺鏡輔助手術(shù)治療慢性硬膜下血腫[J];臨床神經(jīng)外科雜志;2014年03期

5 楊剛;廖勇仕;;慢性硬膜下血腫發(fā)病機(jī)制的研究進(jìn)展[J];中國(guó)微侵襲神經(jīng)外科雜志;2013年10期

6 何兵孝;程小玉;張毅飛;賀曉生;;慢性硬膜下血腫鉆孔引流術(shù)后并發(fā)癥臨床分析[J];中華神經(jīng)外科疾病研究雜志;2009年04期

7 吳鋼群,陳杰,單國(guó)進(jìn),章威;慢性硬膜下血腫鉆孔引流術(shù)后張力性氣顱的防治[J];浙江創(chuàng)傷外科;2002年03期

8 吳近森;諸葛啟釧;瞿宣興;;外傷性慢性硬膜下血腫鉆孔術(shù)后并發(fā)硬膜下張力性氣顱[J];中華創(chuàng)傷雜志;1993年01期

9 王曉平;王木華;林超男;陳小飛;熊暉云;;慢性硬膜下血腫的近期文獻(xiàn)總結(jié)[J];中華神經(jīng)外科雜志;2008年12期

，

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