Xia Dayong, Liu Jiaqiang, Ding Fei, Hu Zhengqing, Qin Feiyun, Zhang Zihuan, Lai Niansheng, Jin Yuelong, Li Zhenbao
Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College).
Department of Neurosurgery, Jing Xian Hospital, Jing Xian, Xuancheng City, Anhui Province.
J Craniofac Surg. 2025 Jul 15. doi: 10.1097/SCS.0000000000011669.
To investigate the therapeutic efficacy of middle meningeal artery (MMA) embolization combined with burr-hole drainage in chronic subdural hematoma (CSDH), to establish an evidence base for clinical decision-making.
A retrospective analysis was conducted on 82 CSDH patients who underwent surgical intervention at The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital) between July 2021 and June 2023. Patients were divided into 2 groups: the control group (burr-hole drainage alone, n=56) and the study group (MMA embolization combined with burr-hole drainage, n=26). Preoperative hematoma volume, age, sex, platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), modified Rankin Scale (mRS) scores (preoperative and postoperative), and postoperative hematoma clearance rates were compared between the 2 groups.
No statistically significant differences were observed in baseline characteristics (age, sex, PLT, PT, APTT), preoperative hematoma volume, or preoperative mRS scores between the 2 groups (all P >0.05). The study group demonstrated significantly better postoperative mRS scores (≤2 points) compared with the control group ( P <0.05). In addition, the study group exhibited superior hematoma clearance rates in both left-sided and right-sided CSDH ( P <0.05).
MMA embolization combined with burr-hole drainage is a safe and effective approach for CSDH treatment, reducing hematoma recurrence and improving patient prognosis.
探讨脑膜中动脉(MMA)栓塞联合钻孔引流术治疗慢性硬膜下血肿(CSDH)的疗效,为临床决策建立循证依据。
对2021年7月至2023年6月在皖南医学院第一附属医院(弋矶山医院)接受手术干预的82例CSDH患者进行回顾性分析。患者分为2组:对照组(单纯钻孔引流,n = 56)和研究组(MMA栓塞联合钻孔引流,n = 26)。比较两组患者术前血肿体积、年龄、性别、血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、改良Rankin量表(mRS)评分(术前和术后)以及术后血肿清除率。
两组患者的基线特征(年龄、性别、PLT、PT、APTT)、术前血肿体积或术前mRS评分比较,差异均无统计学意义(均P > 0.05)。研究组术后mRS评分(≤2分)明显优于对照组(P < 0.05)。此外,研究组在左侧和右侧CSDH中的血肿清除率均更高(P < 0.05)。
MMA栓塞联合钻孔引流术是治疗CSDH的一种安全有效的方法,可减少血肿复发,改善患者预后。