Wang Wenming, Liu Hua, Yang Jian
the First People\'s Hospital.
Turk Neurosurg. 2017 Aug 31. doi: 10.5137/1019-5149.JTN.19747-16.2.
To evaluate the surgical treatment of a chronic subdural haematoma (CSDH). We compared two surgical treatments of CSDH: burr-hole craniostomy irrigation with and without drainage.
We retrospectively studied patients with chronic subdural haematomas admitted to our hospital. A total of 87 patients underwent surgery: 57 were treated via burr-hole irrigation with postoperative drainage (Group BD) and 30 were treated via irrigation without drainage (Group BI).
Two instances of rebleeding developed in Group BD. The cerebral cortex did not expand in one case. One instance of rebleeding developed in Group BI but the cerebral cortex expanded in all cases. The average length of hospitalisation, number of postoperative complications, incidence of rebleeding, and extent of expansion of the cerebral cortex did not differ between the two groups (all P-values 0.05). At the 6-month follow-up, most patients had recovered well. The Glasgow Outcome Scale (GOS) revealed no significant differences between the groups. No significant difference was found between the two surgical treatments in terms of the length of hospitalisation, rebleeding, or expansion of the cerebral cortex (which was complete in all but one patient).
We believe that the key feature of CSDH surgery is thorough irrigation during the operation; whether to use postoperative drainage is not of great importance. We currently use burr-hole irrigation without postoperative drainage.
评估慢性硬膜下血肿（CSDH）的手术治疗方法。我们比较了CSDH的两种手术治疗方法：钻孔开颅冲洗并引流与不引流。
我们对我院收治的慢性硬膜下血肿患者进行了回顾性研究。共有87例患者接受了手术：57例通过钻孔冲洗并术后引流进行治疗（BD组），30例通过冲洗但不引流进行治疗（BI组）。
BD组发生了2例再出血。其中1例脑皮质未扩张。BI组发生了1例再出血，但所有病例脑皮质均有扩张。两组之间的平均住院时间、术后并发症数量、再出血发生率以及脑皮质扩张程度均无差异（所有P值>0.05）。在6个月的随访中，大多数患者恢复良好。格拉斯哥预后量表（GOS）显示两组之间无显著差异。两种手术治疗方法在住院时间、再出血或脑皮质扩张方面（除1例患者外所有患者脑皮质均完全扩张）均未发现显著差异。
我们认为CSDH手术的关键特征是术中彻底冲洗；是否使用术后引流并不重要。我们目前采用钻孔冲洗且术后不引流的方法。
