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重视与否:慢性硬脑膜下血肿(CSDH)患者术后气颅?

Take it seriously or not: postoperative pneumocephalus in CSDH patients?

作者信息

Huang Guo-Hui, Li Xin-Cai, Ren Li, Dai Rong-Xiao, Sun Zhao-Liang, Jiang Xiu-Feng, Feng Dong-Fu

机构信息

Department of Neurosurgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Br J Neurosurg. 2020 Jun;34(3):284-289. doi: 10.1080/02688697.2020.1729343. Epub 2020 Feb 23.

Abstract

Pneumocephalus is a common finding after burr-hole drainage of chronic subdural hematoma (CSDH). Its effects have not been specifically studied. A retrospective analysis was performed in 140 patients with CSDH with single burr-hole drainage. The pre- and postoperative volumes of intracranial hematoma and the postoperative volume of pneumocephalus were calculated and analyzed with their relationships with Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) scores. The preoperative hematoma volume and the patient ages are positively correlated with the 1-day postoperative pneumocephalus volume ( < 0.001,  < 0.01). There is no correlation between postoperative pneumocephalus volume and GCS/GOS scores ( > 0.05) and there is no difference of GCS/GOS scores or CSDH recurrence rate between patients with and without pneumocephalus ( > 0.05). The age and the volume of 1-day postoperative pneumocephalus are positively correlated with the absorbing rate of pneumocephalus ( < 0.01,  < 0.001). The pneumocephalus at a certain range has no effect on the prognosis of patients with CSDH and requires no specific intervention due to its self-absorbing capacity in the normal progress after surgery.HighlightsNo correlation between postoperative pneumocephalus volume and GCS/GOS scores.No difference of GCS/GOS or recurrence between patients with pneumocephalus or not.Pneumocephalus at certain range has no effect on the prognosis of patients.

摘要

气颅是慢性硬膜下血肿(CSDH)钻孔引流术后的常见表现。其影响尚未得到专门研究。对140例行单钻孔引流的CSDH患者进行了回顾性分析。计算并分析了颅内血肿的术前和术后体积以及气颅的术后体积,及其与格拉斯哥昏迷量表(GCS)和格拉斯哥预后量表(GOS)评分的关系。术前血肿体积和患者年龄与术后1天的气颅体积呈正相关(<0.001,<0.01)。术后气颅体积与GCS/GOS评分之间无相关性(>0.05),有气颅和无气颅患者的GCS/GOS评分或CSDH复发率无差异(>0.05)。年龄和术后1天气颅体积与气颅吸收速率呈正相关(<0.01,<0.001)。一定范围内的气颅对CSDH患者的预后无影响,由于其在术后正常进程中有自我吸收能力,无需特殊干预。

要点

术后气颅体积与GCS/GOS评分之间无相关性。

有气颅和无气颅患者的GCS/GOS或复发情况无差异。

一定范围内的气颅对患者预后无影响。

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