Wakabayashi Yukihiro, Yamashita Masanori, Asano Tomoshige, Yamada Akira, Kenai Hiroyuki, Kondoh Yayoi, Hori Yuzo, Nagatomi Hirofumi
Department of Neurosurgery, Nagatomi Neurosurgical Hospital, Oita, Japan.
No Shinkei Geka. 2012 Nov;40(11):967-71.
Chronic subdural hematoma is often seen in elderly patients. One burr hole surgery with subdural drainage has been performed and prognosis is good, but the recurrence rate is still about 10%. To prevent the recurrence, we used Kampo-medicine Gorei-san with tranexamic acid after surgery. The purpose of this study is to investigate if the recurrence is able to prevent by using these drugs.
From January 2008 to December 2010, 199 consecutive cases with chronic subdural hematoma were examined at Nagatomi Neurosurgical Hospital. Patients were divided into four groups according to the administered drugs; Gorei-san, tranexamic acid, Gorei-san with tranexamic acid and no drug groups. The recurrence rate was compared between each group. The chi-square test was performed as a statistical analysis.
In all patients, the mean age was 77.7±10.5 years. There were 140 males and 59 females. Overall recurrence rate was 7.0%. Each recurrence rate was 8.3% in the Gorei-san administration group, and 10.9% in the tranexamic acid group, and 2.9% in Gorei-san with tranexamic acid group, and 5.7% in the no-drug group. There was no significant difference between the four groups in statistical analysis.
Gorei-san with the tranexamic acid administration group had the minimum recurrence. There was no significant difference but these drugs would be preventable recurrence of chronic subdural hematoma. We need to accumulate more cases as a prospective study in the future.
慢性硬膜下血肿常见于老年患者。已进行了单孔钻孔手术及硬膜下引流，预后良好，但复发率仍约为10%。为预防复发，我们在术后使用了汉方药物钩藤散加氨甲环酸。本研究的目的是调查使用这些药物是否能够预防复发。
2008年1月至2010年12月，长富神经外科医院对199例连续的慢性硬膜下血肿患者进行了检查。根据所使用的药物将患者分为四组：钩藤散组、氨甲环酸组、钩藤散加氨甲环酸组和未用药组。比较了每组之间的复发率。采用卡方检验进行统计分析。
所有患者的平均年龄为77.7±10.5岁。男性140例，女性59例。总体复发率为7.0%。钩藤散给药组的复发率为8.3%，氨甲环酸组为10.9%，钩藤散加氨甲环酸组为2.9%，未用药组为5.7%。统计分析显示四组之间无显著差异。
钩藤散加氨甲环酸给药组的复发率最低。虽无显著差异，但这些药物可能预防慢性硬膜下血肿的复发。未来我们需要作为前瞻性研究积累更多病例。
