【摘要】：目的:通過對66例慢性硬膜下血腫CSDH(chronic subdural hematoma)患者的一般資料進(jìn)行分析,同時分別行單純鉆孔沖洗引流術(shù)與開顱血腫清除術(shù)兩種術(shù)式,比較分析出二者的優(yōu)缺點(diǎn),繼而總結(jié)出治療CSDH最為合理、有效、經(jīng)濟(jì)的治療方法。方法:對我院2014年9月到2017年1月延大附院神經(jīng)外科收住的慢性硬膜下血腫的66例住院患者的一般資料進(jìn)行回顧性分析,通過觀察其年齡、血腫量、切口長度、出血量、手術(shù)用時、住院總費(fèi)用、住院總時間、治愈率及并發(fā)癥的發(fā)生率等因素,進(jìn)行統(tǒng)計學(xué)研究分析,比較得出合適慢性硬膜下血腫最佳手術(shù)治療方式。結(jié)果:66例患者均可以順利完成手術(shù)。術(shù)后兩組患者均能在復(fù)查完CT檢查后,順利拔除引流管,手術(shù)切口愈合均良好。對年齡、血腫量及治愈率三個因素分析出,單純鉆孔沖洗引流組與開顱血腫清除組,統(tǒng)計學(xué)分析表明,這兩組之間的差異無明顯統(tǒng)計學(xué)意義(P0.05);但在手術(shù)時間、住院總時間、術(shù)中總出血量、住院總費(fèi)用、并發(fā)癥等方面,單純鉆孔引流術(shù)組明顯優(yōu)于開顱組,統(tǒng)計學(xué)分析后,二者具有明顯統(tǒng)計學(xué)差異(P0.05);兩組在有無并發(fā)癥之間也有明顯統(tǒng)計學(xué)差異(P0.05),而在并發(fā)癥方面,兩組間繼發(fā)性腦損傷這個因素的差異性較明顯(P0.05)。結(jié)論:對此66例CSDH患者的一般資料總結(jié)分析,通過單純鉆孔沖洗引流術(shù)和開顱血腫切除術(shù)這兩種手術(shù)治療方法比較,我們發(fā)現(xiàn),在所有因素內(nèi),年齡、血腫量、治愈率方面,兩組無明顯差異;但在手術(shù)切口長度、出血量、手術(shù)用時、住院總費(fèi)用、住院時間等方面,單純鉆孔沖洗引流組明顯優(yōu)于開顱血腫清除組;并發(fā)癥方面,開顱組明顯多于鉆孔引流沖洗組,其中繼發(fā)性腦損傷這一因素較為突出。
[Abstract]:Objective: to analyze the general data of 66 patients with chronic subdural hematoma (CSDH (chronic subdural hematoma). Then summed up the most reasonable, effective and economical treatment of CSDH. Methods: the general data of 66 patients with chronic subdural hematoma admitted by neurosurgery from September 2014 to January 2017 were analyzed retrospectively. The age, hematoma volume, incision length and bleeding volume were observed. The factors such as the total cost of operation, total hospitalization time, cure rate and incidence of complications were analyzed statistically, and the optimal surgical treatment for chronic subdural hematoma was obtained. Results: all 66 patients were able to complete the operation successfully. After CT examination, the drainage tube was removed smoothly and the incision healed well. Three factors, age, hematoma quantity and cure rate, were analyzed. The statistical analysis showed that there was no significant difference between the two groups (P0.05), but in the operation time, the total length of hospitalization, the total time of operation, the difference between the two groups was not significant (P0.05). The total intraoperative bleeding, total hospital expenses, complications and other aspects were significantly better in the simple drilling and drainage group than in the craniotomy group. There was significant statistical difference between the two groups (P0.05); there was also a significant difference between the two groups in the complications (P0.05), but in the complications, the difference of the secondary brain injury between the two groups was significant (P0.05). Conclusion: the general data of 66 patients with CSDH were summarized and analyzed. By comparing the two surgical methods of simple drilling, irrigation and drainage and craniotomy, we found that, in all factors, age, hematoma volume, cure rate, and so on. There was no significant difference between the two groups, but the length of incision, the amount of bleeding, the total cost of hospitalization, the length of hospitalization, and the length of stay in the two groups were significantly better than those in the group of craniotomy and hematoma removal. Craniotomy group was more than drilling drainage group, and secondary brain injury was more prominent.
【學(xué)位授予單位】：延安大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R651.1

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