临床神经外科杂志2019，Vol.16Issue(6)：492-496,5.DOI:10.3969/j.issn.1672-7770.2019.06.007
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
Therapeutic effect of neuroendoscopic hematoma evacuation and soft-channel drainage on chronic subdural hematoma
摘要
Abstract
Objective To investigate the therapeutic effect of neuroendoscopic hematoma evacuation and soft-channel drainage on chronic subdural hematoma ( CSDH ).Methods 40 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.Results The 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).Conclusions Neurosurgical 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.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Key words
neuroendoscopic hematoma evacuation/soft-channel drainage/chronic subdural hematoma分类
医药卫生引用本文复制引用
吴俊,许文辉,马铁梁,蒋震伟,王清..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(6):492-496,5.基金项目
江苏省科教强卫工程青年医学人才项目(QNRC2016209) （QNRC2016209）
