慢性硬膜下血肿：有引流与无引流钻孔开颅术后复发率的比较
Chronic subdural hematoma: a comparison of recurrence rates following burr-hole craniostomy with and without drains.
作者信息
Kutty Shankar Ayyappan, Johny Mishal
机构信息
Malabar Institute of Medical Sciences, Department of Neurological Sciences, Kozhikode, Kerala, India.
出版信息
Turk Neurosurg. 2014;24(4):494-7. doi: 10.5137/1019-5149.JTN.8830-13.1.
AIM
To compare the rates of recurrence of chronic subdural hematoma following surgical evacuation by one of two methods, namely, using frontal and parietal burr holes without a drain or a single parietal burr hole with the addition of a subdural drain.
MATERIAL AND METHODS
This was a randomized controlled trial with two groups of 70 patients each. Patients in group I had two burr holes and those in group II had a single burr-hole. A subdural drain was placed for the second group, and this was removed 48-72 hours later. Patients were followed up for 3 months and symptomatic recurrences underwent re-exploration.
RESULTS
11 out of 70 patients in group I had recurrent hematomas requiring surgery while only two out of 70 patients in group II had symptomatic recurrences. The difference was statistically significant (p=0.0168).
CONCLUSION
The use of a single burr hole with drain appears to be a safe and effective procedure for the treatment of chronic subdural hematoma.
目的
比较两种手术引流方法治疗慢性硬膜下血肿后的复发率，这两种方法分别是：采用额部和顶部钻孔但不置引流管，以及采用单个顶部钻孔并附加硬膜下引流管。
材料与方法
这是一项随机对照试验，分为两组，每组70例患者。第一组患者有两个钻孔，第二组患者有一个钻孔。第二组放置硬膜下引流管，并在48 - 72小时后拔除。对患者进行3个月的随访，有症状复发的患者接受再次探查。
结果
第一组70例患者中有11例出现复发性血肿需要手术，而第二组70例患者中只有2例出现有症状的复发。差异具有统计学意义（p = 0.0168）。
结论
采用单个钻孔并置引流管的方法似乎是治疗慢性硬膜下血肿的一种安全有效的方法。
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