中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2015年
25期
32-34
,共3页
硬通道%软通道%钻孔引流%慢性硬膜下血肿%高速电钻%老年人
硬通道%軟通道%鑽孔引流%慢性硬膜下血腫%高速電鑽%老年人
경통도%연통도%찬공인류%만성경막하혈종%고속전찬%노년인
Hard channel%Soft channel%Invasive drilling%Chronic subdural hematoma%High speed electric drill%Senior citizens
目的：探讨金属硬通道钻孔引流术在慢性硬膜下血肿（chronic subdural hematoma， CSDH）治疗上的疗效和优点。方法：将58例慢性硬膜下血肿患者随机数字表法分为两组，A组29例采用经头皮切口颅骨钻孔硅胶管置入软通道引流治疗，B组29例采用金属硬通道经皮直接锥颅建立硬通道引流。统计对比两组病例的手术时间、拔管时间、麻醉要求、疗效、复发率、平均住院时间、气颅发生率、感染率等指标。结果：两组患者手术时间、住院时间、气颅发生率、麻醉要求比较，差异均有统计学意义（P<0.05）；而术后拔管时间、复发率、感染率、显效率比较，差异无统计学意义。结论：采用金属硬通道直接锥颅建立硬通道引流治疗CSDH，在手术时间、住院时间、气颅发生率、麻醉要求上明显优于经头皮切口颅骨钻孔硅胶管置入软通道引流治疗CSDH；在感染率、复发率和拔管时间上比较无明显统计学差异，且疗效显著，操作方便，是治疗CSDH最简单、安全、有效的治疗方式，值得临床推广。
目的：探討金屬硬通道鑽孔引流術在慢性硬膜下血腫（chronic subdural hematoma， CSDH）治療上的療效和優點。方法：將58例慢性硬膜下血腫患者隨機數字錶法分為兩組，A組29例採用經頭皮切口顱骨鑽孔硅膠管置入軟通道引流治療，B組29例採用金屬硬通道經皮直接錐顱建立硬通道引流。統計對比兩組病例的手術時間、拔管時間、痳醉要求、療效、複髮率、平均住院時間、氣顱髮生率、感染率等指標。結果：兩組患者手術時間、住院時間、氣顱髮生率、痳醉要求比較，差異均有統計學意義（P<0.05）；而術後拔管時間、複髮率、感染率、顯效率比較，差異無統計學意義。結論：採用金屬硬通道直接錐顱建立硬通道引流治療CSDH，在手術時間、住院時間、氣顱髮生率、痳醉要求上明顯優于經頭皮切口顱骨鑽孔硅膠管置入軟通道引流治療CSDH；在感染率、複髮率和拔管時間上比較無明顯統計學差異，且療效顯著，操作方便，是治療CSDH最簡單、安全、有效的治療方式，值得臨床推廣。
목적：탐토금속경통도찬공인류술재만성경막하혈종（chronic subdural hematoma， CSDH）치료상적료효화우점。방법：장58례만성경막하혈종환자수궤수자표법분위량조，A조29례채용경두피절구로골찬공규효관치입연통도인류치료，B조29례채용금속경통도경피직접추로건립경통도인류。통계대비량조병례적수술시간、발관시간、마취요구、료효、복발솔、평균주원시간、기로발생솔、감염솔등지표。결과：량조환자수술시간、주원시간、기로발생솔、마취요구비교，차이균유통계학의의（P<0.05）；이술후발관시간、복발솔、감염솔、현효솔비교，차이무통계학의의。결론：채용금속경통도직접추로건립경통도인류치료CSDH，재수술시간、주원시간、기로발생솔、마취요구상명현우우경두피절구로골찬공규효관치입연통도인류치료CSDH；재감염솔、복발솔화발관시간상비교무명현통계학차이，차료효현저，조작방편，시치료CSDH최간단、안전、유효적치료방식，치득림상추엄。
Objective: To investigate the effect and advantages of metal hard channel invasive drilling in the treatment of chronic subdural hematoma (CSDH).Method: 58 patients who had chronic subdural hematoma were divided into two groups randomly. Group A: 29 cases underwent incision of scalp skull drilling silicone tube implantation of soft channel drainage treatment. Group B: 29 cases used the metal hard channel to drill skull to build the drainage of hard channel though scalp. Operation time, extubation time, anesthetic requirement, curative effect, the recurrence rate, average hospitalization time, the incidence of intracranial pneumatosis, infection rate, and other indicators between the two groups were compared.Result: Operation time, hospitalization time, incidence of intracranial pneumatosis, anesthetic requirements between the two groups was compared and showed significantly different (P<0.05), but extubation time after surgery, recurrence rate, infection rate, explicit efficiency did not show different.Conclusion: Using the metal hard channel to drill skull to build the drainage of hard channel to cure the CSDH that is better than using the method of incision of scalp skull drilling silicone tube implantation of soft channel drainage treatment in operation time, hospitalization time, the incidence of intracranial pneumatosis, anesthetic requirements. There is no statistically significant difference in the infection rate, recurrence rate and extubation time. Thus, curative effect of metal hard channel invasive drilling is remarkable, the operation is convenient, it is the most simple, safe and effective treatment for CSDH, and worth clinical promotion.
