Gazzeri R, Galarza M, Neroni M, Canova A, Refice G M, Esposito S
Department of Neurosurgery, San Giovanni - Addolorata Hospital, Rome, Italy.
Acta Neurochir (Wien). 2007;149(5):487-93; discussion 493. doi: 10.1007/s00701-007-1139-8. Epub 2007 Mar 28.
Chronic subdural haematoma is one of the most common entities encountered in daily practice. Many methods of treatment have been reported, each with its own advantages and disadvantages.
The authors present a novel technique for the management of chronic subdural haematoma which is a variation of a closed drainage system. After evacuation of the haematoma through a single burr hole, we inserted a Jackson Pratt drain into the subgaleal space, with suction facing the burr hole, allowing for continuous drainage of the remaining haematoma.
We used the method for over 4 years to treat 224 patients. Seventeen patients (7.6%) needed a second operation for a recurrence of the haematoma no patient required a third operation. Postoperative complications developed in 3 patients. Two patients died while in the hospital, a mortality rate of 0.9%.
The use of suction assisted evacuation, is followed by results that compare satisfactorily to reports of previous methods, with a low rate of recurrence and complications. It is relatively less invasive and can be used in high risk patients.
慢性硬膜下血肿是日常医疗实践中最常见的病症之一。已有多种治疗方法被报道,每种方法都有其优缺点。
作者介绍一种治疗慢性硬膜下血肿的新技术,它是闭式引流系统的一种变体。通过单个钻孔排空血肿后,我们将一根杰克逊·普拉特引流管插入帽状腱膜下间隙,吸力朝向钻孔,以便持续引流剩余血肿。
我们使用该方法超过4年,治疗了224例患者。17例患者(7.6%)因血肿复发需要二次手术,无患者需要三次手术。3例患者出现术后并发症。2例患者在住院期间死亡,死亡率为0.9%。
使用负压辅助排空法,其结果与先前方法的报道相比令人满意,复发率和并发症发生率较低。它的侵入性相对较小,可用于高危患者。