Department of Neurosurgery, School of Medicine, Inha University, 27 Inhang-ro, Jung-gu, Incheon 400-711, Korea.
Yonsei Med J. 2013 Sep;54(5):1091-7. doi: 10.3349/ymj.2013.54.5.1091.
To assess the therapeutic value of two different drainage catheters in treating chronic subdural hematoma (CSDH).
Two types of drainage catheters can be used to treat CSDH according to the position of holes in the catheter: open-type or closed-type catheter. In this retrospective study, 199 total patients with CSDH were reviewed according to catheter type. Among them, 84 patients were and 113 in the closed-type group (holes positioned within the distal- most 1 cm of the catheter). The surgeon selected the catheter type. Total drainage volume, initial drainage volume within 2 days, percentage of initial drainage volume per total drainage volume, duration of catheter insertion, and reoperation rate were compared.
Total drainage volume was not different between the two groups (p=0.333). The initial drainage volume within 2 days was larger in the open-type group than closed-type group (p=0.024), but the percentage of initial drainage volume per total drainage volume was not different (p=0.354). The duration of catheter insertion was shorter in the open-type group than closed-type group (p=0.015). The reoperation rate of CSDH was also higher in the open-type group than closed-type group (p=0.004).
CSDH drainage with an open-type catheter is faster compared with a closed-type catheter, but total drainage volume is similar and reoperation rate is higher. Therefore, the open-type catheter for CSDH drainage has limited clinical value.
评估两种不同引流管治疗慢性硬脑膜下血肿(CSDH)的治疗价值。
根据引流管上孔的位置,可使用两种类型的引流管治疗 CSDH:开放式或封闭式导管。在这项回顾性研究中,根据导管类型回顾了 199 例 CSDH 患者。其中,84 例为开放式组(孔位于导管最远端 1cm 内),113 例为封闭式组(孔位于导管最远端 1cm 内)。手术医生选择导管类型。比较两组的总引流量、前 2 天的初始引流量、初始引流量占总引流量的百分比、导管插入时间和再手术率。
两组总引流量无差异(p=0.333)。开放式组前 2 天的初始引流量大于封闭式组(p=0.024),但初始引流量占总引流量的百分比无差异(p=0.354)。开放式组的导管插入时间短于封闭式组(p=0.015)。开放式组的 CSDH 再手术率也高于封闭式组(p=0.004)。
与封闭式导管相比,开放式导管治疗 CSDH 的引流速度更快,但总引流量相似,再手术率更高。因此,开放式导管在治疗 CSDH 方面的临床价值有限。