临床神经外科杂志
臨床神經外科雜誌
림상신경외과잡지
JOURNAL OF CLINICAL NEUROSURGERY
2015年
2期
137-139
,共3页
王良伟%李监松%徐光斌%吴永%潘晶晶%王俊芳
王良偉%李鑑鬆%徐光斌%吳永%潘晶晶%王俊芳
왕량위%리감송%서광빈%오영%반정정%왕준방
慢性硬膜下血肿%钻孔引流术%病理
慢性硬膜下血腫%鑽孔引流術%病理
만성경막하혈종%찬공인류술%병리
chronic subdural hematoma%burr hole subdural drainage%pathology
目的:探讨慢性硬膜下血肿钻孔引流术后再出血的原因及治疗原则。方法回顾性分析2011年7月~2013年6月收治的80例慢性硬膜下血肿钻孔引流术治疗患者的临床资料,其中4例患者出现包膜内出血形成血肿,患者均手术治疗并对血肿外包膜做病理检查。结果3例手术治疗后痊愈,1例因术后并发症死亡。包膜病理检查示,大量新生毛细血管扩张充血,有炎性细胞、胶原纤维和纤维细胞等,包膜内的毛细血管壁不完整。结论慢性硬膜下血肿外膜新生血管结构异常是慢性硬膜下血肿术后包膜内出血的原因之一,包膜内出血一经确诊应首选手术治疗。
目的:探討慢性硬膜下血腫鑽孔引流術後再齣血的原因及治療原則。方法迴顧性分析2011年7月~2013年6月收治的80例慢性硬膜下血腫鑽孔引流術治療患者的臨床資料,其中4例患者齣現包膜內齣血形成血腫,患者均手術治療併對血腫外包膜做病理檢查。結果3例手術治療後痊愈,1例因術後併髮癥死亡。包膜病理檢查示,大量新生毛細血管擴張充血,有炎性細胞、膠原纖維和纖維細胞等,包膜內的毛細血管壁不完整。結論慢性硬膜下血腫外膜新生血管結構異常是慢性硬膜下血腫術後包膜內齣血的原因之一,包膜內齣血一經確診應首選手術治療。
목적:탐토만성경막하혈종찬공인류술후재출혈적원인급치료원칙。방법회고성분석2011년7월~2013년6월수치적80례만성경막하혈종찬공인류술치료환자적림상자료,기중4례환자출현포막내출혈형성혈종,환자균수술치료병대혈종외포막주병리검사。결과3례수술치료후전유,1례인술후병발증사망。포막병리검사시,대량신생모세혈관확장충혈,유염성세포、효원섬유화섬유세포등,포막내적모세혈관벽불완정。결론만성경막하혈종외막신생혈관결구이상시만성경막하혈종술후포막내출혈적원인지일,포막내출혈일경학진응수선수술치료。
Objective To explore mechanism and management of intracapsular bleeding after burr hole subdural drainage for chronic subdural hematoma ( CSDH) .Method The clinical data of 80 patients with CSDH treated with burr hole subdural drainage from July , 2011 to June,2013,were analyzed retrospectively .4 cases were treated with craniotomy because of hematoma in capsule after burr hole subdural drainage , light microscopy was used to observe the ultrastructure of the outer membrane of them .Results 3 patients were cured after craniotomy ,1 died because of complication .Light microscopy showed dilated and congested marcocapillaries with a wide vascular lumen in the outer membrane of the hematoma capsule , including inflammatory cells , collagenous fiber , fibrocyte and so on , endothelial cell in the marcocapillaries was discontinous or partically dissolved .Conclusions Variation of structure of these fragile new vessels may play an important role in bleeding of capsule after burr hole subdural drainage in treatment of CSDH.Craniotomy should be the first line treatment .