Katsuki Masahito, Kawamura Shin, Koh Akihito
Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, Niigata, Japan.
Surg Neurol Int. 2022 Jul 15;13:307. doi: 10.25259/SNI_455_2022. eCollection 2022.
Pharmacological treatment for chronic subdural hematoma (CSDH) recurrence prevention after surgery is under debate. CSDH may be related to (fluid disturbance) from the Japanese herbal perspective. (GRS) treats and is used to prevent a postoperative recurrence. However, not all CSDHs are liquid, and some have structures such as trabecula, hematoma, and clots, suggesting (blood stasis). Therefore, we prospectively investigated the (KBG) effectiveness, which treats , for CSDH recurrence prevention and hematoma resolution compared to GRS.
We prospectively prescribed KBG 7.5 g/day for 12 CSDH patients after burr-hole surgery. As a control cohort, we retrospectively collected 48 patients treated by GRS 7.5 g/day. The recurrence within 1 month and the hematoma thickness after 1 month were evaluated.
The median age was 84 years old. All the patients' symptoms improved after surgery. The median preoperative midline shift and mean hematoma thicknesses were 6.0 mm and 23.75 mm. Those at 1 month were 2.0 mm and 11.43 mm. The recurrence rate was not significantly different between the KBG cohort (1 of 12) and the GRS cohort (4 of 48) ( = 0.999). The KBG's noninferiority to GRS regarding the hematoma thickness at 1 month was statistically proven; KBG (12.26 mm) and GRS (11.20 mm).
The recurrence rate at 1 month was not different between the KBG and GRS cohorts. The hematoma thickness at 1 month in the KBG cohort was not statistically inferior to that in the GRS cohort.
手术后预防慢性硬膜下血肿（CSDH）复发的药物治疗存在争议。从日本草药学角度来看，CSDH可能与（液体紊乱）有关。（GRS）治疗（相关病症）并用于预防术后复发。然而，并非所有CSDH都是液体，有些还具有小梁、血肿和血凝块等结构，提示（血瘀）。因此，我们前瞻性地研究了治疗（相关病症）的（KBG）预防CSDH复发和血肿消退的有效性，并与GRS进行比较。
我们前瞻性地为12例CSDH钻孔手术后患者每天服用7.5克KBG。作为对照队列，我们回顾性收集了48例每天服用7.5克GRS治疗的患者。评估1个月内的复发情况以及1个月后的血肿厚度。
中位年龄为84岁。所有患者术后症状均有改善。术前中位中线移位和平均血肿厚度分别为6.0毫米和23.75毫米。1个月时分别为2.0毫米和11.43毫米。KBG队列（12例中的1例）和GRS队列（48例中的4例）的复发率无显著差异（=0.999）。统计学证明，KBG在1个月时血肿厚度方面不劣于GRS；KBG（12.26毫米）和GRS（11.20毫米）。
KBG和GRS队列1个月时的复发率无差异。KBG队列1个月时的血肿厚度在统计学上不低于GRS队列。
