Liu Xuemeng, Qiu Yongyi, Zhang Jibo, Zhang Qingwen, Chen Lin, Chen Lizhu, Sun Xiangyu
Department of Neurosurgery, FeiXian People Hospital, FeiXian, China.
Department of Neurosurgery, ZhongNan Hospital, WuHan University, WuHan, China.
World Neurosurg. 2018 Dec;120:e1024-e1030. doi: 10.1016/j.wneu.2018.08.219. Epub 2018 Sep 7.
To investigate the clinical benefits of emergent single burr hole evacuation technology in traumatic acute subdural hematoma (ASDH) with cerebral herniation cases.
We conducted a review comparing patients with ASDH with cerebral herniation who underwent single burr hole evacuation followed by decompressive craniectomy and intracranial hematoma removal surgery (n = 45, group A) and those who underwent decompressive craniectomy and intracranial hematoma removal surgery after rapid infusion of mannitol 250 mL (n = 53, group B) in our institution. Pre- and postoperative assessments included Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS), activities of daily living (ADLs), and common complication incidences.
At 1 and 6 months after operation, the median GCS score of group A was significantly higher than group B (P = 0.04 and P = 0.03, respectively). After 6 months, the GOS score and ADLs between the 2 groups had significant differences (P < 0.05). There were no differences between the 2 groups in the common complication incidences.
Emergent single burr hole evacuation in combination with decompressive craniectomy surgery is a useful treatment for ASDH with cerebral herniation, which can achieve reduction of intracranial pressure as soon as possible and improve the prognosis.
探讨急诊单孔钻孔引流技术在创伤性急性硬膜下血肿（ASDH）合并脑疝病例中的临床疗效。
我们进行了一项回顾性研究，比较了在我院接受单孔钻孔引流后行去骨瓣减压及颅内血肿清除术的ASDH合并脑疝患者（n = 45，A组）和在快速输注250 mL甘露醇后行去骨瓣减压及颅内血肿清除术的患者（n = 53，B组）。术前和术后评估包括格拉斯哥昏迷量表（GCS）、格拉斯哥预后量表（GOS）、日常生活活动能力（ADL）以及常见并发症发生率。
术后1个月和6个月时，A组的GCS评分中位数显著高于B组（分别为P = 0.04和P = 0.03）。6个月后，两组之间的GOS评分和ADL有显著差异（P < 0.05）。两组常见并发症发生率无差异。
急诊单孔钻孔引流联合去骨瓣减压术是治疗ASDH合并脑疝的有效方法，可尽快降低颅内压并改善预后。
