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经双大骨瓣钻孔、冲洗及帽状腱膜下低压负压引流治疗慢性硬膜下血肿后的复发率

Recurrence Rate of Chronic Subdural Hematoma after Evacuating It by Two Large Burr Holes, Irrigation, and Subgaleal Low-Pressure Suction Drainage.

作者信息

Abdelfatah Mohamed Abdel Rahman

机构信息

Department of Neurosurgery, Ain Shams University, Cairo, Egypt.

出版信息

Asian J Neurosurg. 2019 Jul-Sep;14(3):725-729. doi: 10.4103/ajns.AJNS_321_17.

Abstract

BACKGROUND

There are no current standard operative steps for chronic subdural hematoma (CSDH). The aim of this study was to detect the recurrence rate after drainage of a unilateral diffuse CSDH by combining certain operative steps.

MATERIALS AND METHODS

This is a descriptive, retrospective cohort study that included 47 consecutive adult patients who underwent evacuation of a unilateral diffuse CSDH by two large burr holes (≥2 cm in diameter) and irrigation of the subdural space by warm saline, followed by placement of a subgaleal Redivac drain under low-pressure suction in our university hospital from August 2012 to August 2016. There were 29 men and 18 women with a mean age of 69.1 years.

RESULTS

All the operations were uneventful. All the patients had adequate drainage of their subdural hematomas, and all patients were discharged alert and oriented. No incidence of recurrence within 12 months after surgery.

CONCLUSION

This study demonstrated that surgical management of a unilateral diffuse CSDH in adult patients by two large burr holes, irrigation, and a subgaleal Redivac low-pressure suction drainage was effective and associated with no recurrence.

摘要

背景

目前对于慢性硬膜下血肿(CSDH)尚无标准的手术步骤。本研究的目的是通过结合特定的手术步骤来检测单侧弥漫性CSDH引流后的复发率。

材料与方法

这是一项描述性回顾性队列研究,纳入了47例连续的成年患者,这些患者于2012年8月至2016年8月在我们大学医院接受了通过两个大骨孔(直径≥2 cm)进行单侧弥漫性CSDH引流、用温盐水冲洗硬膜下腔,随后在低压吸引下放置帽状腱膜下Redivac引流管的手术。其中男性29例,女性18例,平均年龄69.1岁。

结果

所有手术均顺利进行。所有患者的硬膜下血肿均得到充分引流,所有患者出院时神志清醒、定向力正常。术后12个月内无复发情况。

结论

本研究表明,通过两个大骨孔、冲洗以及帽状腱膜下Redivac低压吸引引流对成年患者单侧弥漫性CSDH进行手术治疗是有效的,且无复发。

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