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MMA栓塞联合硬脑膜下穿刺引流与单纯硬脑膜下穿刺引流治疗慢性硬膜下血肿的临床疗效比较

Comparison of clinical efficacy of MMA embolization combined with subdural perforation drainage and subdural perforation drainage in the treatment of CSDH.

作者信息

Cheng Wen, Yang Quanlong, Yuan Xiaodong, Wu Jiangbin

机构信息

Neurosurgery, Affiliated Hospital and Clinical Medical College of Chengdu University, No. 82, North Section 2, Second Ring Road, Jinniu District, Chengdu, Sichuan, China.

Neurosurgery, Affiliated Hospital and Clinical Medical College of Chengdu University, No. 82, North Section 2, Second Ring Road, Jinniu District, Chengdu, Sichuan, China.

出版信息

Neurocirugia (Engl Ed). 2025 Mar-Apr;36(2):75-82. doi: 10.1016/j.neucie.2024.11.001. Epub 2024 Nov 17.

Abstract

BACKGROUND

Chronic subdural hematoma is a frequent neurosurgical illness, and current treatment options mostly include subdural trepanation and drainage alone, as well as middle meningeal artery embolization in conjunction with subdural trepanation and drainage. However, there is currently a lack of extensive study and data support for comparing the clinical results of the two surgical treatment techniques.

OBJECTIVE

The goal of this study is to compare the clinical effects of middle meningeal artery embolization combined with subdural trepanation and drainage versus simple subdural trepanation and drainage in the treatment of chronic subdural hematoma, in order to provide a reliable foundation for clinical selection of appropriate surgical treatment methods.

METHODS

This study included 71 patients with chronic subdural hematoma, who were divided into two groups according to the procedure: observation group (n = 25) and control group (n = 46). The control group received only basic subdural drilling and drainage.

CONCLUSIONS

This study found that MMA embolization combined with subdural trepanation and drainage provides a greater therapeutic benefit in the treatment of chronic subdural hematoma. The observation group outperformed the control group in terms of postoperative CT results, Barthel index, and clinical effect, as well as operating time. Furthermore, the observation group's complications and recurrence rate were much lower than the control group's.

摘要

背景

慢性硬膜下血肿是一种常见的神经外科疾病,目前的治疗选择主要包括单纯硬膜下钻孔引流,以及脑膜中动脉栓塞联合硬膜下钻孔引流。然而,目前缺乏对这两种手术治疗技术的临床结果进行比较的广泛研究和数据支持。

目的

本研究的目的是比较脑膜中动脉栓塞联合硬膜下钻孔引流与单纯硬膜下钻孔引流治疗慢性硬膜下血肿的临床效果,为临床选择合适的手术治疗方法提供可靠依据。

方法

本研究纳入71例慢性硬膜下血肿患者,根据手术方式分为两组:观察组(n = 25)和对照组(n = 46)。对照组仅接受基本的硬膜下钻孔引流。

结论

本研究发现,脑膜中动脉栓塞联合硬膜下钻孔引流在慢性硬膜下血肿治疗中具有更大的治疗益处。观察组在术后CT结果、Barthel指数、临床效果以及手术时间方面均优于对照组。此外,观察组的并发症和复发率远低于对照组。

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