慢性硬膜下血肿患者D-二聚体检测的意义及氨甲苯酸术中冲洗血肿腔对其复发的影响

摘要

Objective To determine the content of D-dimer in peripheral blood and hematoma fluid of patients with chronic subdural hematoma,and to study the effect of the use of aminomethylbenzoic acid with irrigation treatment in burr hole drainage on the recurrence of CSDH.Methods Forty-nine patients with CSDH were randomly divided into experimental group and control group,the content of D-dimer in peripheral venous plasma and hematoma fluid was measured,and aminomethylbenzoic acid was used to irrigate hematoma cavity in the experiment group,while physiological saline was used to irrigate hematoma cavity in the control group,postoperative follow-up for 3 months and the recurrence rate was compared.Results There was no difference in the content of D-dimer in peripheral blood and hematoma fluid of two groups in the experimental group and control group(P>0.05). Self control of CSDH patients,D-dimer in hematoma fluid increased significantly than that in peripheral blood(P<0.01).The re-currence rate of the experimental group was lower than that of the control group(P<0.05).Conclusion D-dimer may play an im-portant role in the pathogenesis of CSDH.Aminomethylbenzoic acid can inhibit fibrinolysis and irrigating the hematoma cavity can reduce the recurrence of CSDH.%目的：测定慢性硬膜下血肿(chronic subdural hematoma,CSDH)患者外周血和血肿液中D-二聚体的含量,探讨钻孔引流术中应用氨甲苯酸冲洗血肿腔对CSDH 复发的影响。方法将49例CSDH 患者随机分入试验组和对照组,测定外周静脉血和血肿液中D-二聚体的含量,试验组术中应用氨甲苯酸冲洗血肿腔,对照组应用生理盐水冲洗血肿腔,术后随访3个月,比较复发率。结果(1)2组外周血和血肿液中D-二聚体含量差异无统计学意义(P>0.05)；(2)CSDH 患者自身对照,血肿液中D-二聚体含量较外周血明显升高(P<0.01)。(3)试验组术后复发率低于对照组(P<0.05)。结论 CSDH 患者血肿液中 D-二聚体含量增高可能与其发病有关。氨甲苯酸可抑制纤溶亢进,术中冲洗血肿腔可降低CSDH 的复发。