标题：不同手术方法治疗慢性硬膜下血肿的临床疗效比较

      作者：张江红，高国栋，宗建海    (空军军医大学唐都医院神经外科，陕西 西安 710043)

      卷次： 2018年29卷23期

      【摘要】 目的 比较钻孔引流术和微创穿刺术治疗慢性硬膜下血肿的临床疗效。方法 选取空军军医大学唐都医院神经外科于2017年1月至2018年5月期间收治的80例慢性硬膜下血肿患者为研究对象，根据随机数表法分为两组，每组40例，其中钻孔组采用钻孔引流术治疗，微创组采用微创穿刺引流术治疗。比较两组患者围手术期的临床指标(如切开长度、术中出血量、手术时间、住院时间)和并发症，以及治疗总有效率。结果 微创组患者的切口长度、术中出血量、手术时间、住院时间分别为(0.5±0.3) cm、(6.8±2.8) mL、(27.5±9.9) min、(8.9±3.2) d，均明显少于钻孔组的(4.6±1.6) cm、(56.4±19.7) mL、(58.2±21.4) min、(12.1±4.6) d，差异均有统计学意义(P<0.05)；钻孔组患者的治疗总有效率为 95.0%，与微创组的 90.0%比较差异无统计学意义(P>0.05)；微创组患者术后并发症发生率为12.0%，明显低于钻孔组的30.0%，差异有统计学意义(P<0.05)。结论 钻孔引流术和微创穿刺术均是治疗慢性硬膜下血肿的有效手术方式，但是微创穿刺术具有创伤小、出血少、手术时间短及术后并发症发生率低的优点。
      【关键词】 慢性硬膜下血肿；钻孔引流；微创；并发症；疗效
      【中图分类号】 R651.1+5 【文献标识码】 A 【文章编号】 1003—6350（2018）23—3299—03

Comparison of clinical effects of different surgical methods for chronic subdural hematoma.
ZHANG Jiang-hong,GAO Guo-dong, ZONG Jian-hai. Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an710043, Shaanxi, CHINA
【Abstract】 Objective To compare the clinical effect of drilling drainage and minimally invasive puncture inthe treatment of chronic subdural hematoma. Methods A total of 80 patients with chronic subdural hematoma in De-partment of Neurosurgery, Tangdu Hospital, Air Force Medical University from January 2017 to May 2018 were selectedand divided into two groups according to the random number table method, with 40 patients in each group. The drillinggroup was treated by drilling and drainage, and the minimally invasive group was treated by minimally invasive punc-ture and drainage. The perioperative clinical indexes such as incision length, intraoperative bleeding volume, operationtime, hospitalization time, complications and total effective rate were compared between the two groups. Results Theincision length, intraoperative bleeding volume, operation time and hospitalization time of the minimally invasive groupwere (0.5±0.3) cm, (6.8±2.8) mL, (27.5±9.9) min, (8.9±3.2) d, which were significantly lower than (4.6±1.6) cm, (56.4±19.7) mL, (58.2±21.4) min, (12.1±4.6) d of the drilling group (P<0.05). There was no significant difference in total effec-tive rate between drilling group (95.0%) and minimally invasive group (90.0%), P>0.05. The postoperative complica-tions rate in the minimally invasive group (12.00%) was significantly lower than that in the drilling group (30.00%), andthe difference was statistically significant (P<0.05). Conclusion Drilling drainage and minimally invasive puncture areboth effective methods for the treatment of chronic subdural hematoma, but minimally invasive puncture has the advan-tages of less trauma, less bleeding, shorter operation time, and lower postoperative complications.
      【Key words】 Chronic subdural hematoma; Drilling drainage; Minimally invasive; Complications; Curative effect·论 著·doi:10.3969/j.issn.1003-6350.2018.23.014基金项目：国家自然科学基金(编号：81572697)