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神经内镜钻孔引流术治疗慢性硬膜下血肿的疗效评估:一项观察性研究。

Efficacy evaluation of neuroendoscopy burr hole drainage in the treatment of chronic subdural hematoma: An observational study.

作者信息

Wang Xue-Jian, Yin Yu-Hua, Wang Zhi-Feng, Zhang Yi, Sun Cheng, Cui Zhi-Ming

机构信息

Department of Neurosurgery, Affiliated Hospital 2 to Nantong University, Nantong 226001, Jiangsu Province, China.

Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University, Shanghai 200000, China.

出版信息

World J Clin Cases. 2022 Dec 16;10(35):12920-12927. doi: 10.12998/wjcc.v10.i35.12920.

Abstract

BACKGROUND

Chronic subdural hematoma (CSDH) is a common disease in neurosurgery. The traditional treatment methods include burr hole drainage, bone flap craniectomy and other surgical methods, and there are certain complications such as recurrence, pneumocephalus, infection and so on. With the promotion of neuroendoscopic technology, its treatment effect and advantages need to be further evaluated.

AIM

To study the clinical effect of endoscopic small-bone approach in CSDH.

METHODS

A total of 122 patients with CSDH admitted to our hospital from August 2018 to August 2021 were randomly divided into two groups using the digital table method: the neuroendoscopy group ( = 61 cases) and the burr hole drainage group ( = 61 cases). The clinical treatment effect of the two groups of patients with CSDH was compared.

RESULTS

At the early postoperative stage (1 d and 3 d), the proportion of 1/2 re-expansion of brain tissue in the hematoma cavity and the proportion of complete re-expansion was higher in the neuroendoscopy group than in the burr hole drainage group, and the difference between the two groups was statistically significant ( < 0.05). The recurrence rate of hematoma in the neuroendoscopy group was lower than that in the burr hole drainage group, and the difference between the two groups was statistically significant ( < 0.05). No intracranial hematoma, low cranial pressure, tension pneumocephalus or other complications occurred in the neuroendoscopy group.

CONCLUSION

The neuroendoscopic approach for the treatment of CSDH can clear the hematoma under direct vision and separate the mucosal lace-up. The surgical effect is apparent with few complications and definite curative effect, which is worthy of clinical promotion and application.

摘要

背景

慢性硬膜下血肿(CSDH)是神经外科的常见疾病。传统治疗方法包括钻孔引流、骨瓣开颅等手术方式,且存在一定并发症,如复发、气颅、感染等。随着神经内镜技术的推广,其治疗效果及优势有待进一步评估。

目的

探讨神经内镜小骨窗入路治疗CSDH的临床效果。

方法

采用数字表法将2018年8月至2021年8月我院收治的122例CSDH患者随机分为两组:神经内镜组(n = 61例)和钻孔引流组(n = 61例)。比较两组CSDH患者的临床治疗效果。

结果

术后早期(1 d和3 d),神经内镜组血肿腔内脑组织1/2复张比例及完全复张比例高于钻孔引流组,两组差异有统计学意义(P < 0.05)。神经内镜组血肿复发率低于钻孔引流组,两组差异有统计学意义(P < 0.05)。神经内镜组未发生颅内血肿、低颅压、张力性气颅等并发症。

结论

神经内镜治疗CSDH能在直视下清除血肿并分离黏膜粘连。手术效果明显,并发症少,疗效确切,值得临床推广应用。

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