[1]吴俊,许文辉,马铁梁,等.神经内镜血肿清除术与软通道引流术对慢性硬膜下血肿的疗效分析[J].临床神经外科杂志,2019,16(06):492-496.[doi:10.3969/j.issn.1672-7770.2019.06.007]
 WU Jun,XU Wen-hui,MA Tie-liang,et al.herapeutic effect of neuroendoscopic hematoma evacuation and soft-channel drainage on chronic subdural hematoma[J].Journal of Clinical Neurosurgery,2019,16(06):492-496.[doi:10.3969/j.issn.1672-7770.2019.06.007]
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神经内镜血肿清除术与软通道引流术对慢性硬膜下血肿的疗效分析()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年06期
页码:
492-496
栏目:
脑出血专题
出版日期:
2019-12-03

文章信息/Info

Title:
herapeutic effect of neuroendoscopic hematoma evacuation and soft-channel drainage on chronic subdural hematoma
文章编号:
20190607
作者:
吴俊许文辉马铁梁蒋震伟王清
214200 宜兴,宜兴市人民医院神经外科(吴俊,许文辉,蒋震伟),中心实验室(马铁梁);无锡市第二人民医院(王清)
Author(s):
WU Jun XU Wen-hui MA Tie-liang et al.
Department of Neurosurgery, People’s Hospital of Yixing, Yixing 214200, China
关键词:
神经内镜血肿清除术软通道引流术慢性硬膜下血肿
Keywords:
neuroendoscopic hematoma evacuation soft-channel drainage chronic subdural hematoma
分类号:
R651.1+1
DOI:
10.3969/j.issn.1672-7770.2019.06.007
文献标志码:
A
摘要:
【摘要】目的探讨神经内镜血肿清除术与软通道引流术对慢性硬膜下血肿的治疗效果。方法选取宜兴市人民医院神经外科2016年8月—2018年8月收治的40例慢性硬膜下血肿患者为研究对象,按照手术方案分为神经内镜组和软通道引流组。神经内镜组患者采用神经内镜下血肿清除术治疗,软通道引流组患者采用软通道引流术治疗。记录两组患者的手术相关指标,复查CT血肿清除程度,并通过神经功能缺损评分(CSS)、日常生活活动能力(ADL)评分评判患者术前、术后神经功能、日常生活能力。术后随访3个月,统计患者术后血肿复发及并发症情况。结果术后即刻、术后3 d软通道引流组血肿清除率明显高于神经内镜组(均P<0.05),但术后5 d、30 d血肿清除率较术后即刻明显降低,且明显低于神经内镜组(均P<0.05)。而神经内镜组术后3 d、5 d、30 d血肿清除率均较术后即刻明显增高(均P<0.05)。两组术后并发症发生率的差异无统计学意义(P>0.05)。术后神经内镜组患者CSS评分明显低于软通道引流组,ADL评分明显高于软通道引流组(均P<0.05)。结论神经内镜下血肿清除术和软通道引流术治疗慢性硬膜下血肿均能有效清除颅内血肿,改善神经功能。神经内镜血肿清除术远期血肿清除效果要明显优于软通道引流术,且术中可有效降低对脑血管及组织损伤,能更好地促进患者神经功能及生活能力恢复;可以作为临床治疗慢性硬膜下血肿首选方案。
Abstract:
Abstract: ObjectiveTo investigate the therapeutic effect of neuroendoscopic hematoma evacuation and soft-channel drainage on chronic subdural hematoma(CSDH). Methods40 patients with CSDH who underwent neurosurgery from August 2016 to August 2018 were enrolled in the study. They were divided into soft-channel drainage group and neuroendoscopy group according to the surgical plan. Soft-channel drainage group was used for soft-channel drainage. In the neuroendoscopy group, neuroendoscopic hematoma evacuation was performed. The surgical related indexes of the two groups were recorded, and the CT hematoma clearance was reviewed. The neurological deficit score(CSS) and activity of daily living ability(ADL) were evaluated. The preoperative and postoperative neurological function and daily living ability of the patients were followed up for 3 months. The recurrence and complications of postoperative hematoma were counted. ResultsThe hematoma clearance rate of the soft-channel drainage group was significantly better than that of the neuroendoscopy group immediately after surgery and 3 days after surgery(all P<0.05). However, the hematoma clearance rate was significantly lower than that after surgery on the 5th and 30th day after surgery. It was lower than the neuroendoscopy group(all P<0.05). The hematoma clearance rate of the neuroendoscopy group was significantly higher than that of the postoperative after 3 days, 5 days, and 30 days(all P<0.05). The incidence of postoperative complications was not statistically significant(P>0.05). The postoperative neurological endoscopy group had a much lower CSS than the soft-channel drainage group, and the ADL score was much higher than that of the soft-channel drainage group(all P<0.05). ConclusionsNeurosurgical hematoma evacuation and soft-channel drainage for CSDH can effectively eliminate intracranial hematoma and improve neurological function. Neuroendoscopic hematoma removal is superior to soft-channel drainage in the treatment of long-term hematoma. It can effectively reduce cerebral vascular and tissue damage, and promote the neurological function and life ability recovery of patients. It can be used as the first choice for clinical treatment of CSDH.
更新日期/Last Update: 2019-12-04