Zhang Jian-ping, Xu Wen-hui, Zhu Li-ping, Zhang Xiang
Department of Neurosurgery, the People's Hospital of Yixing City, Yixing 214200, China.
Chin J Traumatol. 2003 Jun;6(3):142-4.
To sum up the causes of recurrence of chronic subdural hematoma (CSDH) from failure of trepanation and drainage and explore its prevention and treatment.
From October 1988 to June 2002 a total of 358 patients with CSDH were treated with trepanation and drainage in our hospital. Among them 15 patients had recurrence of CSDH after operation. The data of the 15 patients were reviewed retrospectively.
Of the 15 patients, 13 were cured by retrepanation and redrainage, one cured by removal of hematoma by craniotomy with bone flap, and one, a 1-year old child, gave up reoperation due to severe encephalatrophy.
Most CSDHs which recur after trepanation and drainage can be cured by retrepanation and redrainage. For the patients with repeated recurrence of CSDH removal of hematoma capsule can be considered. The causes of recurrence of CSDH are related to disease course, the thickness of hematoma capsule, the severity of encephalatraphy and whether the hematoma cavity is drained or irrigated completely, and operation methods.
总结钻孔引流术治疗慢性硬膜下血肿（CSDH）失败致复发的原因，探讨其防治方法。
回顾性分析1988年10月至2002年6月我院收治的358例行钻孔引流术治疗的CSDH患者资料，其中15例术后复发。
15例中，13例经再次钻孔引流治愈，1例经开颅去骨瓣清除血肿治愈，1例1岁患儿因严重脑萎缩放弃再次手术。
钻孔引流术后复发的多数CSDH经再次钻孔引流可治愈。对反复复发的CSDH患者可考虑切除血肿包膜。CSDH复发原因与病程、血肿包膜厚度、脑萎缩严重程度、血肿腔是否充分引流或冲洗及手术方式有关。
