中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
32期
24-27
,共4页
赵广祚%于广杰%李海燕%王朝晖
趙廣祚%于廣傑%李海燕%王朝暉
조엄조%우엄걸%리해연%왕조휘
血肿,硬膜下%引流术%复发
血腫,硬膜下%引流術%複髮
혈종,경막하%인류술%복발
Hematoma,subdural%Drainage%Recurrence
目的 探讨影响慢性硬脑膜下血肿术后复发的手术相关因素.方法 回顾性分析236例经钻孔引流手术治疗的慢性硬脑膜下血肿患者的临床资料,对钻孔部位、引流管位置、术后颅内积气量、残留液及引流时间等情况进行对比分析.结果 236例患者中,单侧血肿177例,双侧血肿59例,共计295个血肿.复发27例,其中双侧血肿患者复发9例,单侧血肿患者复发18例.年龄、性别构成、酗酒、出血倾向、单双侧血肿、钻孔部位、引流管位置、术后颅内积气量和残留液与术后复发率无显著相关性(P＞0.05).术后复发率为9.2％(27/295).引流时间≥3 d患者复发率为3.5％(5/143),而引流时间＜3d患者复发率为14.5％(22/152),两者比较差异有统计学意义(P＜0.01).年龄≥60岁患者中,引流时间≥3 d患者术后复发率[3.4％(4/119)]显著低于引流时间＜3d患者[16.2％(18/111)],差异有统计学意义(P＜0.01);而年龄＜60岁患者中,引流时间≥3d患者及引流时间＜3d患者术后复发率比较差异无统计学意义[4.2％(1/24)比9.8％(4/41),P＞0.05].结论 对老年慢性硬脑膜下血肿患者,钻孔引流术后的引流时间应延长至3d,而对较为年轻的患者则可缩短引流时间.
目的 探討影響慢性硬腦膜下血腫術後複髮的手術相關因素.方法 迴顧性分析236例經鑽孔引流手術治療的慢性硬腦膜下血腫患者的臨床資料,對鑽孔部位、引流管位置、術後顱內積氣量、殘留液及引流時間等情況進行對比分析.結果 236例患者中,單側血腫177例,雙側血腫59例,共計295箇血腫.複髮27例,其中雙側血腫患者複髮9例,單側血腫患者複髮18例.年齡、性彆構成、酗酒、齣血傾嚮、單雙側血腫、鑽孔部位、引流管位置、術後顱內積氣量和殘留液與術後複髮率無顯著相關性(P＞0.05).術後複髮率為9.2％(27/295).引流時間≥3 d患者複髮率為3.5％(5/143),而引流時間＜3d患者複髮率為14.5％(22/152),兩者比較差異有統計學意義(P＜0.01).年齡≥60歲患者中,引流時間≥3 d患者術後複髮率[3.4％(4/119)]顯著低于引流時間＜3d患者[16.2％(18/111)],差異有統計學意義(P＜0.01);而年齡＜60歲患者中,引流時間≥3d患者及引流時間＜3d患者術後複髮率比較差異無統計學意義[4.2％(1/24)比9.8％(4/41),P＞0.05].結論 對老年慢性硬腦膜下血腫患者,鑽孔引流術後的引流時間應延長至3d,而對較為年輕的患者則可縮短引流時間.
목적 탐토영향만성경뇌막하혈종술후복발적수술상관인소.방법 회고성분석236례경찬공인류수술치료적만성경뇌막하혈종환자적림상자료,대찬공부위、인류관위치、술후로내적기량、잔류액급인류시간등정황진행대비분석.결과 236례환자중,단측혈종177례,쌍측혈종59례,공계295개혈종.복발27례,기중쌍측혈종환자복발9례,단측혈종환자복발18례.년령、성별구성、후주、출혈경향、단쌍측혈종、찬공부위、인류관위치、술후로내적기량화잔류액여술후복발솔무현저상관성(P＞0.05).술후복발솔위9.2％(27/295).인류시간≥3 d환자복발솔위3.5％(5/143),이인류시간＜3d환자복발솔위14.5％(22/152),량자비교차이유통계학의의(P＜0.01).년령≥60세환자중,인류시간≥3 d환자술후복발솔[3.4％(4/119)]현저저우인류시간＜3d환자[16.2％(18/111)],차이유통계학의의(P＜0.01);이년령＜60세환자중,인류시간≥3d환자급인류시간＜3d환자술후복발솔비교차이무통계학의의[4.2％(1/24)비9.8％(4/41),P＞0.05].결론 대노년만성경뇌막하혈종환자,찬공인류술후적인류시간응연장지3d,이대교위년경적환자칙가축단인류시간.
Objective To study the surgery factors on chronic subdural hematoma(CSH)recurrence.Methods Two hundred and thirty-six patients with CSH were treated with trepanation and drainage.It was analyzed retrospectively on location of burr-hole,location of drainage tube,volume of intracranial pneumatocele,residual hematoma and drainage time etc.Results Half hematoma was in 177cases,two sides hematoma was in 59 cases,total was 295 hematomas.Twenty-seven hematomas were recurrent,9 cases were two sides hematoma,and 18 cases were half hematoma.There was no significant difference between recurrence rate and age,sex,drunkenness,hemorrhagic tendency,half or two sides hematoma,location of burr-hole,location of drainage tube,volume of intracranial pneumatocele and residual hematoma(P＞0.05).The recurrence rate was 9.2％(27/295).There was significant difference in recurrence rate between drainage time ≥ 3 d and＜3 d[3.5％(5/143)vs.14.5％(22/152),P＜0.01].In age ≥ 60years patients,there was significant difference in recurrence rate between drainage time ≥ 3 d and＜3 d[3.4％(4/119)vs.16.2％(18/111),P＜0.01].But in age＜60 years patients,there was no significant difference in recurrence rate between drainage time ≥ 3 d and＜3 d[4.2％(1/24)vs.9.8％(4/41),P＞0.05].Conclusion It should be taken more than 3 d of drainage time for old patients with CSH,while shorten time for young patients with CSH.
