Oral Sukru, Borklu Resul Emin, Kucuk Ahmet, Ulutabanca Halil, Selcuklu Ahmet
Department of Neurosurgery, Kayseri Training and Research Hospital, Kayseri, Turkey.
Department of Neurosurgery, Tunceli State Hospital, Tunceli, Turkey.
North Clin Istanb. 2015 Sep 26;2(2):115-121. doi: 10.14744/nci.2015.06977. eCollection 2015.
One or two burr-hole craniostomies with subgaleal or subdural drainage system and irrigation are the most common methods for surgical treatment of CSDH. The aim of this study is to compare the advantages or disadvantages of these techniques used for CSDH.
Seventy patients were treated by burr-hole subdural drainage or subgaleal drainage system with irrigation. Our patients were classified into two groups according to the operative procedure as follows: Group I, one or two burr-hole craniostomy with subgaleal closed system drainage and irrigation (n=36), Group II, one or two burr-hole craniostomies with subdural closed drainage system and irrigation (n=38). We compared male and female ratios, complication rates, and age distribution between groups.
There was no remarkable difference between recurrence rates of the two groups. Recurrence rate was 6.25% in Group I and 7.8% in Group II. Subdural empyema occurred in one of the patients in Group II. Symptomatic pneumocephalus did not develop in patients. Four patients were reoperated for recurrence at an average of 12-20 days after the operation with the same methods.
Both of the techniques have a higher cure rate and a lower risk of recurrence. However, subgaleal drainage system is relatively less invasive, safe, and technically easy. So it is applicable for aged and higher risk patients.
采用一个或两个骨孔开颅术并结合帽状腱膜下或硬脑膜下引流系统及冲洗是慢性硬膜下血肿（CSDH）手术治疗最常用的方法。本研究的目的是比较这些用于CSDH的技术的优缺点。
70例患者接受了骨孔硬脑膜下引流或帽状腱膜下引流系统并冲洗治疗。根据手术操作将我们的患者分为两组如下：第一组，一个或两个骨孔开颅术并采用帽状腱膜下封闭系统引流及冲洗（n = 36），第二组，一个或两个骨孔开颅术并采用硬脑膜下封闭引流系统及冲洗（n = 38）。我们比较了两组之间的男女比例、并发症发生率和年龄分布。
两组的复发率之间无显著差异。第一组的复发率为6.25%，第二组为7.8%。第二组中有1例患者发生了硬脑膜下积脓。患者未发生有症状的气颅。4例患者因复发在术后平均12 - 20天采用相同方法再次手术。
两种技术均有较高的治愈率和较低的复发风险。然而，帽状腱膜下引流系统相对侵袭性较小、安全且技术操作简单。所以它适用于老年和高风险患者。
